Specialized training and experience can help therapists address the needs of adoptees, adoptive and foster families, and birth parents at different stages of life.
By Catherine Bianchi, Ph.D.
Guest contributor | Clinical psychologist in Morristown
Adoption is a lifelong experience that can shape identity, relationships and emotional development. When adoptees, adoptive families or birth parents seek therapy, finding a clinician with specialized training in adoption can help ensure their experiences are understood and addressed.
An adoption-competent therapist understands adoption and its potential effects on the people involved. These include members of the adoption triad: adoptees, adoptive parents and birth parents. Their work may also extend to foster families, relatives providing kinship care and others in a child’s support network.
When searching for a therapist, ask about formal training, continuing education and experience with people whose circumstances are similar to yours. Adoption-related needs vary, and being adopted does not, by itself, mean someone needs therapy.
Understanding adoption across a lifetime
An adoption-competent therapist recognizes adoption as a way to form a family and understands its history, processes and different circumstances. Adoption through foster care, international adoption and adoption by relatives can involve different experiences. The degree of contact with birth family also varies.
Some adopted children and teens need support with emotional, behavioral or relationship difficulties. An adoption-competent therapist understands how early experiences may affect development and mental health, while also considering the person’s strengths, current relationships and other possible sources of distress.
A framework described by Sharon Kaplan Roszia and Allison Davis Maxon identifies seven core issues in adoption and permanency: loss, rejection, shame and guilt, grief, identity, intimacy, and mastery and control. These are themes to explore in understanding a person’s experience, rather than diagnoses or a checklist that applies identically to everyone.
These issues may arise at different ages and become more prominent during adolescence or other transitions. Families sometimes seek help for distress or a crisis without recognizing that adoption-related questions or feelings may be contributing.
Loss and grief can be central. Adoption involves separation from birth parents or changes in those relationships, even when it also brings safety, stability and loving family connections. Some adoptees and birth parents experience ambiguous loss, a loss that lacks clear resolution or closure and may not be fully acknowledged by others.
An adoption-competent therapist helps individuals and families discuss these experiences without assuming how anyone should feel about them.
Identity questions can become especially important during adolescence and young adulthood. For adoptees, these may involve birth family, culture, race or a sense of belonging. In transracial or international adoption, therapy may help families support a child’s cultural and racial identity and respond to bias or discrimination.
Attachment, trauma and family communication
Early relationships help shape a child’s sense of safety and trust. When caregiving has been disrupted, some children may have difficulty trusting others or forming close relationships. Therapy can help address those difficulties and support parents in strengthening the parent-child bond.
Trauma may also be relevant, particularly for children who experienced abuse, neglect or repeated changes in caregivers before adoption or during foster care. An adoption-competent therapist considers how those experiences may affect development and behavior. Anxiety, anger or withdrawal can have several causes and require assessment in the context of the child’s history.
Communication is another frequent focus. Children may have questions about their history or identity that they find difficult to ask, while parents may be unsure how to answer. A therapist can help families develop communicative openness, making room for questions, uncertainty and different feelings about adoption.
When working with children, therapy often includes parents or caregivers, through family sessions, separate consultations or guidance on responding to the child’s needs. The form of that involvement should reflect the child’s age, treatment needs, safety and privacy.
Assessment considers a person’s history, development, relationships and current difficulties. Adoption-related experiences should inform that assessment without replacing consideration of other mental health or developmental conditions. When medication is part of care, therapists can collaborate with the prescribing professional to consider its role alongside other treatment and support.
Supporting birth parents, kinship families and changing relationships
Adoption-competent therapists also work with birth parents before and after adoption. Therapy may address grief, loss, adjustment and the circumstances surrounding an adoption plan or separation. This work requires respect for each person’s experience, without stereotypes or judgment.
Relatives who become caregivers may face loyalty conflicts, guilt or uncertainty about changing family roles. Kinship care therapy can help families discuss these concerns and clarify relationships and responsibilities.
Contact with birth family is another area where support may be useful. An adoption-competent therapist understands closed, semi-open and open adoption arrangements and helps families consider boundaries, contact and relationships as circumstances change. Social media, DNA testing, searches for birth relatives and reunions can introduce additional questions.
Therapists may also help children and families prepare for adoption and permanency. Tools such as lifebooks, which document a child’s personal history, and family maps, which illustrate relationships, can help people understand and discuss their stories. Preparation may also include addressing infertility-related grief or helping siblings adjust.
What to ask a prospective therapist
Adoption competence involves knowledge and skills that may inform several treatment approaches, including trauma-informed, attachment-based and family systems therapies. A therapist should be able to explain the approach they propose and how it relates to the person’s needs.
Useful questions include:
- What formal training and continuing education have you completed in adoption, foster care or kinship care?
- What experience do you have working with adoptees, birth parents or families with circumstances similar to ours?
- How do you assess adoption-related concerns alongside other mental health or developmental needs?
- How do you involve parents or caregivers while respecting a child’s privacy and safety?
- How do you address race, culture, birth-family relationships and questions about identity?
- How will we establish treatment goals and review progress?
Respectful language matters, too. Terms such as birth parent and adoptive parent describe relationships more accurately than language that implies only one parent is a real parent. A therapist should also respect the terms individuals use for themselves and their families.
Helpful therapy considers adoption when it is relevant, avoids automatically attributing every difficulty to it, and examines more than behavior alone. It makes room for the individual’s history, family relationships and own understanding of their experience.
The Center for Adoption Support and Education (C.A.S.E.), which provides adoption-competency training, summarizes research on client satisfaction and reported child and family improvements on its Adoption Competency: State of Practice page. The findings are relevant to understanding specialized care, but they do not guarantee a particular outcome for an individual or family.
C.A.S.E.’s national directory lists professionals who have completed its Training for Adoption Competency or National Adoption Competency Mental Health Training Initiative programs. The organization states that inclusion documents training completion and does not constitute an endorsement or certification of a clinician’s skills. Training is one consideration alongside relevant experience, licensure and the fit between therapist and client.
Adoption resources in New Jersey
Several organizations offer information, education or support for people connected to adoption:
- Concerned Persons for Adoption provides educational and networking resources and maintains an events calendar. Its 2026 family conference is listed for Nov. 14 in Somerville.
- Morristown Post-Adoption Support Group is listed by NJ ARCH as a free group for adoptees, birth and adoptive parents, and family members. Despite its name, the listing places meetings in Boonton. Contact the organizer to confirm current meeting arrangements.
- New Jersey Adoption Resource Clearing House, known as NJ ARCH, provides resource listings, information about support groups, and educational materials.
- C.A.S.E. lists webinars, support groups and other events, including online offerings. Check individual listings for eligibility, registration requirements and fees.
These resources can provide a starting point for finding support. Before beginning therapy, discuss the clinician’s training, relevant experience and proposed treatment approach, along with practical questions about fees, insurance and availability.
About the author: Catherine Bianchi, Ph.D., is a licensed clinical psychologist and psychoanalyst who has maintained a practice in Morristown since 1995. She assesses and treats children, adolescents and adults, with experience in adoption, trauma and early developmental experiences. Her work includes adoptees, adoptive families, birth parents, and foster children and families. She is a graduate of C.A.S.E.’s Training for Adoption Competency program.
Bianchi is a faculty member and training analyst at the Center for Psychotherapy and Psychoanalysis of New Jersey and a faculty member at the Metropolitan Institute for Training in Psychoanalytic Psychotherapy. She has served for two decades as a field supervisor for the Rutgers Graduate School of Applied and Professional Psychology and has taught in its clinical psychology doctoral program. She has also provided training to mental health professionals, attorneys and child welfare agencies, including the New Jersey Division of Child Protection and Permanency.
Reference: Roszia, S.K., and Maxon, A.D. (2019). Seven Core Issues in Adoption and Permanency: A Comprehensive Guide to Promoting Understanding and Healing in Adoption, Foster Care, Kinship Families and Third Party Reproduction. Jessica Kingsley Publishers.