Professionals 2017-08-11T01:10:18+00:00

For Professionals

PACER receives inquiries from many professionals who serve the adoption community through education, research, mental health/medicine, and social work.  Most are interested in increasing their awareness about the impact of adoption on children, families, and adult clients. There are many many experts out there, some who have dedicated their entire lives to this population. We have listed some resources below for the professional community seeking to further their exposure to adoption-related work.

We believe its helpful to start by understanding the 7 core issues in those with an adoption experience as stated in Lifelong Issues in Adoption by Silverstein & Kaplan (1982).

7 Lifelong Core Issues in Adoption


Loss: Fear ultimate abandonment; loss biological, genetic, cultural history; Issues of holding on and letting go
Rejection: Personalize placement for adoption as rejection; issues of self-esteem; can only be chosen if first rejected. Anticipate rejection; mis-perceive situations.
Guilt & Shame: Deserving misfortune; shame of being different; may take defensive stance/anger
Grief: Grief may be overlooked in childhood, blocked by adult, leading to depression/acting out; may grieve lack of “fit” in adoptive family
Identity: Deficits in information may impede integration of identity; may see search for identity in early pregnancies, extreme behaviors in order to create sense of belonging
Intimacy: Fear getting close and risk reenacting earlier losses; Concerns over possible incest: bonding issues may lower capacity for intimacy
Control: Adoption alters life course; not party to initial decisions; haphazard nature of adoption removes cause and effect continuum


Loss: Ruminate about lost child. Initial loss merges with other life events; leads to social isolation; changes in body and self-image; relationship losses
Rejection: Reject selves as irresponsible, unworthy because permitted adoption; turns these feelings against self as deserving rejection; come to expect and causes rejection
Guilt & Shame: Party to guilty secret; shame/guilt for placing child; judged by others; double bind: not OK to keep child and not OK to place
Grief: Grief acceptable only short period but may be delayed 10-15 years; lack rituals for mourning; sense of shame blocks grief work.
Identity: Child is part of identity goes on without knowledge; diminished sense of self & self-worth; may interfere with future parental desires
Intimacy: Difficulty resolving issues with other birth parent may interfere with future relationships; intimacy may equate with loss
Control: Relinquishment seen as out of control disjunctive event, interrupts drive for self-actualization


Loss: Infertility equated with loss of self & immortality. Issues of entitlement lead to fear of loss of child and overprotection
Rejection: Ostracized because of procreation difficulties; may scapegoat partner; expect rejection; may expel adoptee to avoid anticipated rejection
Guilt & Shame: Shame of infertility; may believe childlessness is curse or punishment; religious crisis
Grief: Must grieve loss of “fantasy” child; unresolved grief may block attachment to adoptee; may experience adoptee’s grief as rejection
Identity: Experience diminished sense of continuity of self; are not parents
Intimacy: Unresolved grief over losses may lead to intimacy/marital problems; may avoid closeness with adoptee to avoid loss
Control: Adoption experiences lead to “learned helplessness” sense mastery linked to procreation lack generativity

Some additional primers include The Developing Mind by Daniel Siegel and the first section of Coming Home to Self by Nancy Verrier which is clinically focused.

Adoption Competency

The term “adoption competent” refers to the range of awareness professionals may have around the core issues experienced by those living with adoption narratives. This is a rather new term used by practitioners and experts to communicate the need for professionals to increase their knowledge and experience as a way to deliver higher quality care to adoptees (both children and adults), birthparents (potential birthparents) and adoptive parents (pre and post adoption). Research cited by Leslie Pate MacKinnon shows that most families will go through 10 or more therapists before finding one they feel is competent enough to help them. Whether you already have a client whom you suspect is working through adoption issues or you want more exposure, here are some resources we recommend:

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