Because of major worldwide demographic changes, many Latin American children are frequently adopted in the U.S. This article presents an overview of the historical and contemporary circumstances and controversies surrounding intercountry adoptions (ICAs), and a review of possible risk factors for later child or adolescent maladjustment. Although a number offollow-up studies indicate a 70-80% positive outcome, some ICAs end in painful family-child disruptions. There is, therefore, a growing need for bilingual/bicultural mental health services to improve the initial adjustment process and to facilitate a positive long-term outcome. These services are especially needed when the child is older at arrival and the adopting family lives in a mostly homogeneous community. Suggested prearrival, arrival, and follow-up interventions with the family, the child, and the school are described. A case illustration of the interventions offered to a U.S. family and their recently adopted Latin American child is provided.