Adoption in Flux: How Can Social Workers Prepare?

by Shelley Steenrod, MSW, LICSW, PhD

     November is National Adoption Month and a good time to update social workers on trends related to child adoptions in the U.S. Without a doubt, COVID-19 caused a steep decline in all adoptions. However, prior to the pandemic, important demographic changes were already occurring across public and private adoptions. These changes have important implications for social workers, both now and in the future.  

Demographic Changes

COVID-19

     The National Council for Adoption attributes significant decreases in child adoptions to the COVID-19 pandemic. For example, between 2019 and 2020, adoptions from foster care decreased 13%, from 66,087 to 57,794. Over this same time period, intercountry adoptions declined from 2,971 to 1,622.  Finally, private domestic adoptions also decreased from 25,737 in 2019 to 19,658 in 2020, a 24% drop.

     Such dramatic decreases can be attributed to multiple factors. From the perspective of pregnant women, COVID-19 limited access to health care providers and social workers who might have offered adoption as an option for unplanned pregnancies. On the other side, prospective adoptive parents (PAP) were unable to meet with social workers for required home study sessions, travel for intercountry adoptions, or host foster children waiting for permanent families. 

Domestic Infant Adoption

     Although exacerbated by the COVID-19 pandemic, domestic infant adoptions in the U.S. have been steadily declining for several years. Olga Khazan, in an article for The Atlantic, found that an overall reduction in the American birth rate combined with greater acceptance of single parenthood has led to fewer parents making adoption plans for newborns. There is also increased public and private support being directed to pregnant women—such as food, car seats, clothing, and cribs—making raising a child easier from a financial perspective.

     Of course, a decrease in the number of infants available for adoption has implications for those wanting to adopt, primarily couples struggling with infertility, LGBTQIA+ couples, and single people. Many adoption agencies have either paused or stopped accepting new applications for domestic infant adoptions. Bethany Christian Services writes, “Across the country, for each of the roughly 18,000 infants placed for adoption each year, there are dozens of individuals and couples already waiting…. In nearly every case, expectant parents who choose adoption select the family they want to parent their child.  This means wait times will vary greatly with no guarantee of an approved adoptive family being selected.”

Intercountry Adoption

     For complex reasons, intercountry adoptions have also seen a steep decline over the last several years. For example, Russia closed adoptions to the U.S. for political leverage in 2013. Other countries, such as Ethiopia, passed legislation to outlaw intercountry adoption in 2018 on the heels of fraudulent adoption practices and the abuse and murder of an Ethiopian adoptee at the hands of her adoptive family. At the same time, many countries are developing their own domestic adoption programs so that orphaned and vulnerable children can maintain kinship and cultural bonds within their own countries. Finally, some countries, including China and South Korea, only adopt out older children or those with special needs.

Domestic Adoptions From Foster Care

     Prior to the COVID-19 pandemic, adoptions from foster care were steadily increasing, and they are likely to rebound, given the number of children waiting for families and families wanting to adopt. The Annie E. Casey Foundation, Kids Count Data Center, reports that in 2020 there were 117,470 children in foster care waiting for permanent, adoptive homes. Of these, 3% were children under the age of one, 40% between the ages of one and five, 26% between the ages of six and 10, 24% ages 11-15, and 7% ages 16-20. Roughly 66% of foster children waiting for adoption are children of color, while the remaining 44% are categorized as non-Hispanic white children.

‌‌ Implications for Social Workers

     Social workers have always played key roles in child adoption services. These include counseling pregnant women, providing psychoeducation to potential adoptive parents, conducting comprehensive home studies, and facilitating post-adoption services. However, the changing demographics described above not only impact children and families—they also influence the work of social workers in the field of adoption.

     For example, social workers will need to prepare pre-adoptive parents, many of whom are hoping to adopt a baby, for the decrease in available infants through domestic and international adoption programs. Social workers should also promote the possibility of adopting through foster care while also clearly assessing potential adoptive parents for their willingness and ability to parent children who have experienced trauma in the form of abuse and neglect. Social workers who provide pre-adoption services should be sure to educate parents that “although adoption is often a joyful and exciting occasion, it can also give rise to lifelong challenges for members of the adoption constellation—adoptees, birth parents and their extended family members, and adoptive parents and their extended family members.” To this end, social workers must be prepared to help birth parents work through feelings of profound loss as they make an adoption plan for their child and beyond. Meanwhile, adoptive parents have to work through heavy feelings of disappointment and grief when traditional or alternative means of conception and childbirth are ineffective, before they can fully welcome an adopted child into their home.

     Social workers employed in post-adoption services also have their work cut out for them. Experts emphasize that adoption-competent therapists should be able to recognize and work with clients on the seven core issues of adoption identified as loss, rejection, shame and guilt, grief, identity, intimacy, and mastery and control. For adoptees, identity development is particularly salient. Questions such as “Who am I?” “Where did I come from?” and “To whom do I belong?” are central to identity development across the life span, and social workers should prepare adoptive parents for these and many other questions. Social workers can rely on developmental models of identity formation to guide adoptive parents on what and how to share adoption-related material at various ages and stages.

     Experts note that preschool children should know they are adopted, have basic knowledge of their adoption story, and understand that they are identified with two families. School-aged children, buoyed by logic and abstract thinking, will ask questions geared to their specific family. At this stage, school-aged children will be able to understand that their family formed differently from those of their peers and will want explanations about why they were relinquished for adoption and why their family chose them to adopt. Children at this stage may also begin to grieve the loss of birth and extended family and culture. Social workers should help adoptive parents answer questions openly and honestly and help children make sense out of their history.  Most importantly, adoptive children need to know that parents can handle all of their feelings and questions about adoption. During adolescence, identity development is even more complex as youth begin to integrate personal, familial, and sociocultural factors related to adoption. Questions about adoption and birth family often resurface and intensify and may include the desire to search and reach out to the birth family. Social workers can help adoptive parents avoid feeling threatened by these requests and understand them as developmentally appropriate. Adoptees themselves may seek out therapy in an attempt to braid their past, present, and future selves together. 

     Children adopted from foster care have, by definition, been exposed to neglect and abuse and may bring maladaptive beliefs and behaviors into their adoptive homes. According to Holt International, an adoption and family strengthening agency, “Trauma and neglect are both a huge piece of what adoptees have experienced. These two add up to huge changes in the brain that need a therapy that can create felt safety in the adoptee, which will calm the hyper-reactive fight, flight or freeze responses they experience.”

     Adoption-competent social workers should become trained in intervention models that adoptive families can employ. One such intervention is called Trust-Based Relational Intervention (TBRI), an attachment-based, trauma-informed parenting approach for children with a history of relationship-based trauma, including abuse, neglect, institutionalization, and/or multiple foster-care placements.

     A second and quite unique intervention model is called Treehouse. Founded in 2006 in Massachusetts, Treehouse is an intergenerational community with three core principles: 1) All children deserve a permanent, loving family. 2) Every older adult deserves a life filled with purpose and meaning. 3) Given the proper environment and support, these diverse generations will help to meet each other’s needs.  

     At Treehouse, families adopting children and youth from foster care live in a close-knit neighborhood where housing is affordable, and people of all ages invest in one another’s health and well-being.  Children and families receive the support and services necessary to overcome the educational and social/emotional challenges often caused by early neglect, abuse, and trauma. For more information on the award-winning, evidence-based model, visit Treehouse Foundation.

     It is also crucial that adoption-competent therapists listen to the lived experience and wisdom of adoptees. Michelle Madrid-Branch, an adult adoptee and adoptee-advocate, dispels the oft repeated narrative that adopted children should be grateful to have found a family. She stresses that “a child has moved from one world and into another. He or she has been removed from a first life and into a new one. No matter the joy, the expectation, or overflowing love that awaits them; there is trauma left within the gap that separates these two lives and it must be addressed, heard, and supported.”

     Adult adoptees of color are also speaking out about their experiences of being raised by white parents in white communities. In an article by Rachel Hatzipanagos titled “I know my parents love me, but they don’t love my people,” she notes, “Transracial adoptees, people raised by adoptive parents of a different race or ethnicity, are experiencing their own racial reckoning as the nation confronts its historical scars. Most of these adoptions involve White families and children-of-color who, now as adults, are reflecting on the racism they experienced that their parents couldn’t see and rarely talked about.”  

     Clearly, social workers have to do their own anti-racism work to work effectively with transracial families. Ellen Pinderhughes, PhD, writes:

Adoption professionals must also do the personal work to enable them to provide effective support for families. As the expert, professionals need to have the expertise and comfort level to talk with parents about cultural socialization and preparation-for-bias. Before placement, professionals can initiate the self-reflection work parents need to do. After placement and throughout transracial adoptees’ development, professionals need to be ready to help parents support their children’s identity needs.

     There are multiple resources available to social workers who want to become more adoption competent. For example, the Center for Adoption Support and Education and the National Training Initiative (NTI) offer free, web-based, interactive programs for professionals dedicated to addressing the mental health and developmental needs of children in foster, adoptive, or guardianship families (https://adoptionsupport.org/nti/training). The first program is a 20-hour curriculum designed specifically for child welfare workers. The second program is a 30-hour curriculum developed for mental health providers.  Upon completion, NASW-approved continuing education credits are awarded for a small fee.   

     To summarize, the landscape of adoption has rapidly shifted. Domestically, more birth parents are choosing to raise their children, leading to fewer infants available for adoption. Likewise, the number of intercountry adoptions has decreased 94% from its peak in 2004. The largest proportion of children available for adoption are those currently in foster care as a result of previous abuse or neglect. However, for these children, “adoption is a significant protective factor, bringing permanency, safety and a nurturing environment to children who have generally been in less-than-adequate situations.”

     It is important for social workers to reflect on these trends, update their knowledge base, address their cultural and racial biases, and improve their practice skills. Resources are available to become adoption-competent, and National Adoption Month is the perfect time to begin!

Shelley Steenrod, MSW, LICSW, PhD, is a professor at the School of Social Work at Salem State University in Salem, MA.