Adoption & Mental HealthAccording to the Adoption Network, approximately 7 million Americans have been adopted. Currently there are approximately 1.5 million adopted children in the United States. This number indicates that 1 out of 50 children, which represents about 2% of children in the US, are adopted. In other words, the population of individuals who have been adopted represent a pretty significant demographic in our country! This is wonderful as adoption provides many children with loving, supportive and stable homes that they may not have otherwise. However, while adoption is a great opportunity for many families and children in need, the process does not come without its challenges.

About Adoption and Mental Health

According to Lyes and Homeyer, mental health issues such as anxiety, depression, ADHD and behavioral and attachment disorders are significant among adopted children. In fact, approximately 12% of adopted children struggle with issues of attachment. This is something that can come as a shock to some adoptive families. In her dissertation, Kara Carnes-Holt referenced a survey conducted in 2005 by Karyn Purvis and David Cross that showed only 7% of adoptive parents felt “absolutely prepared” for the consequences of “institutional care” on their adopted child. As you can imagine, adoptive parents and families often feel discouraged, inadequate and frustrated when it comes to connecting with their adopted child. Although, it is important to consider the impact that the child’s experiences, prior to the adoption, has on his or her ability to adjust and connect normally. David M. Brodzinsky stated, “It is not adoption status per se that typically leads to the more serious adjustment difficulties of these children, but rather the adverse circumstances that pre-dated their placements; for example, the legacy of genetically-based problems, negative prenatal experiences (exposure to drugs and alcohol), and pre-placement adversities such as malnutrition, neglect, abuse, parental psychopathology, and exposure to the deprivations commonly associated with orphanage life.”

How Therapy Can Help With The Mental Health Aspects of Adoption

When it comes to addressing these issues, clinicians work with adoptive families in therapeutic settings to build trust and connection between family members. Researchers have found that when it comes to addressing attachment issues in children, parental involvement in therapy is incredibly important. Carnes-Holt explored the use of Child-Parent Relationship Therapy (CPRT) and its effects on behavioral issues, relationship stress and parental empathy in adoptive families and found promising results. CPRT is a therapeutic approach that is used by clinicians to teach parents the use of basic child-centered play therapy skills such as reflective listening, limit setting, self-esteem building and the structuring of weekly play sessions with the child. These techniques help create a sense of security and safety that allows the relationship between parent and child to strengthen over time. Through her research, Carnes-Holt found that the adoptive families that participated in CPRT showed a decrease in behavioral issues, a decrease in relationship stress and an enhancement in parents’ empathy.

At Garrett Counseling, we have clinicians trained in the use of Child-Parent Relationship Therapy (CPRT) ready to help you and your child heal and grow closer together. Contact us today at (256) 239-5662 or online by clicking here.


US Adoption Statistics: Adoption Network. Adoption Network |. (2021, November 4). Retrieved November 4, 2021, from

Brodzinsky, D. M. (2011). Children’s understanding of adoption: Developmental and clinical implications. Professional Psychology: Research and Practice, 42(2), 200–207.

Carnes-Holt, K. (n.d.). Child-parent relationship therapy (Cprt) with adoptive families: Effects on child behavior, parent-child relationship stress, and parental empathy (dissertation).

Lyles, M., & Homeyer, L. E. (2014). The use of sandtray therapy with adoptive families. Adoption Quarterly, 18(1), 67–80.

This article was written by Chloe Ball, LPC.