Risk factors for mental health diagnoses among children adopted from the public child welfare system

Adoption Counselors' Perspectives of Counseling Postadoptive Families

“…Securing a permanent and supportive family home has been associated with positive outcomes for foster care children (Barth, Crea, John, Thoburn, & Quinton, ; Triseliotis, ; Triseliotis, Hill, & Borland, ), yet, the elevated occurrence of chronic emotional–behavioral problems among this population of children can alienate family members, destabilize family units, and result in up to 25% of adoptions being legally dissolved—often referred to as disrupted (Dorsey, Conover, & Revillion‐Cox, ; Purvis, Cross, & Pennings, ). Researchers have found that the stressors associated with adopting a foster care child and the risk of a damaging disruption can be militated in part through access to and participation in adoption services (Barth et al, ; Dorsey et al, ; Hartinger‐Saunders, Trouteaud, & Matos‐Johnson, ; Hussey, Falletta, & Eng, ). Although family and individual counseling has been identified as a central component of adoptive services (Brooks, Allen, & Barth, ; Houston & Kramer, ), the majority of knowledge driving therapeutic interventions in the counseling field is based on theoretical work and research conducted outside of the counseling discipline.…”

“…Foster care children have disproportionately high experiences of toxic substances in utero, limited prenatal care, prematurity, low birth weight, abuse, neglect, trauma, and sexual and physical abuse (Purvis, Cross, & Sunshine, ). Secondary risk factors relate to the age of adoption, ethnicity, male gender, and number of prior placements (Hussey et al, ). Most notable is the prevalence of mental illness among children exiting the foster system to permanent homes, with rates currently estimated at 47% (Hussey et al, ).…”

“…Secondary risk factors relate to the age of adoption, ethnicity, male gender, and number of prior placements (Hussey et al, ). Most notable is the prevalence of mental illness among children exiting the foster system to permanent homes, with rates currently estimated at 47% (Hussey et al, ).…”

“…Legal statutes provide free access to mental health services for parents who adopt through the state, yet low service usage and unmet service needs are associated with parental dissatisfaction and have been found to predict 26% of the variance in adoption dissolution (Triseliotis, ). Although the balance of research indicates access to family counseling contributes to family stability and permanence over time (Barth et al, ; Dorsey et al, ), the preponderance of studies examining the impact of interventions on adoptive families are dated, and have been conducted by researchers within the social work discipline (Barth et al, ; Brooks et al, ; Hussey et al, ; Leathers, ; Triseliotis, ; Triseliotis et al, ). To date, counseling journals have published predominately conceptual papers highlighting factors that may contribute to the psychological well‐being of adoptive families (Capps, ; Carnes‐Holt, ; Janus, ; Stinehart, Scott, & Barfield, ).…”

“…Foster care children are an exceptionally vulnerable population, for whom adoption may present a promising alternative to a childhood spent as a ward of the state (Triseliotis, ; Triseliotis et al, ), yet up to 25% of state adoptions are terminated predominately for reasons associated with the child's mental health (Hussey et al, ). Although therapy services are embedded in the range of services afforded by legal statutes to children adopted from the welfare system, the counseling community is largely unclear about systemic treatment options that may contribute to family permanency.…”