Child Psychiatry

Adopting As a Child Psychiatrist: Lessons Learned

Over 100,000 children are adopted each year in the United States.

Over 100,000 children are adopted each year in the United States.

As a child and adolescent psychiatrist, I see children ages 2-18, adults with developmental disabilities, and specialize in the areas of trauma, neurodiversity, foster care and adoption. Finally, I am also an adoptive mother and used to be a foster mother. As an “expert” on adoption, trauma, and developmental disabilities, what advice do I have for adoptive or pre-adoptive parents? Listen to adoptees. As an adoptive mom to special needs children has prepared me in multiple ways. My medical training as a child psychiatrist has no doubt helped me in this journey. My own experiences as the daughter of an adoptee and as someone who is neurodiverse herself have helped me in this journey. However, the best thing I have ever done was listen. Through listening to adoptees and former foster youth, I come away with four significant opinions of adoption.

  1. Adoption, the majority of the time, is unnecessary.

  2. Even when it is essential, adoption always begins with trauma.

  3. Adoptive and foster parents are not equipped to be trauma-informed parents.

  4. Our children are not given adequate tools to navigate their feelings.

On this journey, I have come to understand the systemic issues that lead to a lot of needless adoptions (not exactly what people want to hear, but true). The fact is, that trauma begets trauma and that most foster care related adoptions are due to neglect (not abuse) and infant adoptions are due to lack of resources (not lack of wanting to be a parent). There are, of course, some cases where physical or sexual abuse leads to necessary removal or parents do not want to parent (regardless of resources or societal interventions), but those cases are a much smaller number than we are led to believe. Therefore, many adoptions are a result of a fundamental failure of society to take care of its’ people in treating their mental health and providing support. Becoming an adoptive and foster parent has opened my eyes to just how pervasive our systemic failures genuinely are. We know how to fix this. We have the research. We, as a society, must be willing to invest in children and families. However, this is a point that we, as a society, have not yet reached.

Adoption always begins with loss or trauma, oftentimes both. As adoptive parents, it is our childrens’ best interests to acknowledge this and hold space for this fact, even in infant adoptions. There is the loss of a mother they bonded to for nine months and even more so the loss of a family they are now legally no longer a part of. When we understand this fact, we will be able to serve our children so much better. We are not offended by the thought of open adoptions or the notion that the children will want to explore that loss, which can happen in multiple ways.

The amount of training that I had as a foster parent for trauma-informed parenting is laughable. The training I had was not necessarily useless; it was just extremely superficial. Foster and adoptive parents need to be taught the importance of the first family, the importance of being honest and open with your kids, the benefits of open adoptions and finally, how to parent in a trauma-informed manner. I learned some trauma-informed practices as a child psychiatrist, but even that was inadequate. A lot of this I have discovered myself through research and again listening to adoptees. Connected parenting and trauma-informed parenting is sorely lacking and is beneficial for all children, but especially for adopted children.

Our children are not given adequate tools to navigate their feelings about having two families, of being adopted and of transracial adoptions. They certainly are not taught how to manage their feelings around any history of trauma. Many therapists and psychiatrists are not trauma-informed or do not understand the nuances of adoptions. Lots of things are explained away as attachment issues that are trauma and need to be treated as such. A lot of adoptive parents are not aware or able to separate their feelings about adoption and allow themselves to be a safe space for their children.

We need to approach adoption with the understanding that: we need to do a better job of keeping families together, we need to listen to adult adoptees without defensiveness, we need to understand trauma and we need to allow our children the space to grieve what they have lost and work through their complicated feelings. When we utilize that approach, we can make the best of what is a less than ideal situation. If you are interested in becoming an adoptive parent, my recommendation is to join groups that are adoptee-centered. Follow adoptee activist. Listen, learn, honestly evaluate your reasoning and invest in learning about trauma. This list forms the building blocks to becoming a suitable adoptive parent.