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Article Excerpt
Adults adopted as infants (N = 156) were surveyed to determine the degree to which they had sought help or guidance with psychological issues during adolescence and adulthood. Less than 12% reported seeking help and women sought help more frequently than men. When they sought professional help, they mostly utilized counselors, psychologists, and psychiatrists, but frequently sought help from other sources such as friends, family, and support groups. The results of the study are discussed in light of literature that suggests this population is more frequently referred for help and recommendations are made for practice and research.
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Adoption is an issue that affects 6 out of 10 people in the United States, either directly or indirectly (Evan B. Donaldson Adoption Institute, 1997). The statistics on adoption demonstrate the extent to which adoption permeates our society. There are roughly 120,000 adoptions in the United States every year (U.S. Department of Health and Human Services [USDHHS], 2004). In 2000, for the first time, the U.S. government recognized the importance of studying adopted children and collected information on this population in the U. S. census.
Even though adoption is common in the United States, the research on the long-term outcomes of adoption is scarce (Lears, Guth, & Lewandowski, 1998). Much of it has focused on adjustment of adoptees in childhood and adolescence. Some research has shown adoptees struggle with a variety of psychological issues (e.g. Brodzinsky, Schechter, & Henig, 1992; Common Clinical Issues Among Adoptees, 1995; Issues facing adult adoptees, n.d.; Leon, 2002; Nickman, 1996; Stevens, 1995) and that some of those issues may persist into adulthood (Melina & Roszia, 1993; Child Welfare Information Gateway, formerly National Adoption Information Clearinghouse [CWIG], 2004). Additional studies have shown that adoptees are more likely than the general population to be treated for academic, emotional, or behavioral problems and be over-represented in mental and psychiatric hospitals. (Lears et al.; Miller et al., 2000). In contrast, other researchers have argued that individuals who are adopted experience no more mental health problems than individuals who are not adopted (Benson, Sharma, & Roehlkepartain, 1994a, 1994b; Hochman & Huston, 1995) and that most issues are resolved by adulthood (Nickman). Furthermore, the literature is clear about the degree to which children and adolescents are referred for help (Grotevant, 2000; Miller et al.), but less information exists about adult help-seeking behavior.
With about 20% of adoptions in the United States being domestic infant adoptions by non-relatives (Stolly, 1993; USDHHS, 2004), and with the lack of control for age of adoption in existing research literature, we chose to focus on this population. In order to better understand the help-seeking behaviors of individuals who are adopted, we decided to study adults who were adopted during infancy to determine the degree to which they reported seeking help or guidance on psychological issues during adolescence and adulthood and where they sought help.
Demographics of Adoption
During the 2000 Census, the government collected data for the first time on the number of adopted children living in U. S. households and a number of variables related to their adoption. The data revealed that 2.1 million adopted children and 4.4 million step children were living in American households. A higher percentage of Black children than White children were adopted. Thirteen percent were foreign born. Girls were adopted more often than boys because women prefer adopting girls and more girls are available through international agencies. In general, adopted children lived in families that were better off economically, compared to children who lived with their biological parents, and their parents were more often married, more highly educated, and more likely to own homes. A higher percentage of the adopted children than non-adopted children under age 18 had at least one disability, especially a learning disability, Attention Deficit Disorder, or mental disabilities related to maternal drug use, alcohol fetal syndrome, or other medical conditions (Kreider, 2003).
Psychological Issues
Some of the psychological issues that commonly occur among individuals who are adopted include a sense of loss, grief, shame, rejection, intimacy, control, identity formation, and depression (CWIG, 2004, 1995; Miller et al., 2000). A sense of loss seems to be inherent in adoption for all parties involved (Leon, 2002). Because adoptees lose their birth parents, they are deprived of health information, social history, cultural history, and status (Nickman, 1996). Feelings of loss are rarely completely resolved (Silverstein & Kaplan, 1982) and may intensify at milestone events, such as graduations, marriages, and childbirths. At these times, adoptees may wonder whether birthparents are thinking of them and how they would react to these milestones (Issues Facing Adult Adoptees, n.d.).
Loss often leads to grief, particularly if the adoptee has very little contact with the birth parents (Common Clinical Issues Among Adoptees, 1995; Hochman & Huston, 1995; Leon, 2002; Silverstein & Kaplan, 1982). Grief results from feeling unwanted and abandoned, as well as losing birth parents, possible siblings, culture, and religious heritage (Hayden, 1994). In children, unresolved grief may affect concentration, academics, self-esteem, identity, or peer relationships (Bower, 1994; Frank, 1991; Smith, 1993). The full impact of the grief may not be recognized until adolescence or adulthood when delayed or unexpressed grief can result in depression, delinquency, substance abuse, and aggressive behavior (Bower; Silverstein & Kaplan).
Feelings of rejection may result from adoptees' beliefs that their birth parents rejected them (Leon, 2002), and that they do not fit into their adopted family (Hochman & Huston, 1995). They may wonder whether there is something innately wrong with them that contributed to being un-chosen then chosen, and they may become convinced that they deserved to be rejected. This line of thought can result in resentment of the birth family, shame, or lowered self-esteem and self-concept (Bower, 1994; Common Clinical Issues Among Adoptees, 1995; Issues Facing Adult Adoptees, n.d.; Silverstein & Kaplan, 1982; Soria, 1984). As a result, they may avoid situations where they could potentially be rejected again (Silverstein & Kaplan).
The shame associated with adoption is often unrecognized by members of the adoption triad (birth parents, adoptive parents, adoptee) (Silverstein & Kaplan, 1982), yet feeling ashamed is a common feeling for adoptees (Common Clinical Issues Among Adoptees, 1995; Leon, 2002; Silverstein & Kaplan; Smith, 1993). Exacerbating this feeling is the secrecy sometimes associated with adoption practices (Silverstein & Kaplan).
A child who is adopted as an infant has no control over the decisions made at that time. The child does not choose to leave birth parents or choose the adopted family with whom to live (Common Clinical Issues Among Adoptees, 1995; Silverstein & Kaplan, 1982). If adopted children feel they have constantly been a pawn, they may be angry, engage in power struggles with authority figures, attempt to take control of their lives, and search for birth families (Hochman & Huston, 1995; Common Clinical Issues Among Adoptees, 1995; Hayden, 1994; Silverstein & Kaplan).
Adoption issues may become particularly salient during adolescence when adoptees enter Erikson's (1963) stage of identify formation (Silverstein & Kaplan, 1982). This is a time when all adolescents are struggling with issues of work and love, building relationships with role models and peers, making tentative steps into the adult world, and evaluating everything around them, including people, ideas, and values. For adolescents who are adopted, there are additional issues. They may begin to question their ancestry and search for identification figures (CWIG, 2006, 2005a). To complicate an already turbulent time, they must try to reconcile their relationships with two different sets of parents (Hochman & Huston, 1995). They may fantasize about what their lives would be like if they had stayed with their biological parents and rebel against their adoptive parents (CWIG, 2006, 2005a; Soria, 1984). As a result, they may be intensely reflective, emotional, and preoccupied with their adoptive status, and experience inner conflict, self-doubt, and guilt (Grotevant, 2001; Hochman...
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