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Nurturing a Child with Mental or Emotional Health Problems

Most children who are adopted lead healthy, normal lives. They need the same things all children do: love, care, attention and discipline. Research has shown that adopted children lead better lives than children who live long-term in institutions, foster care, or in homes with parents who abuse, neglect, or are ambivalent about parenting them.

Adoptions—with loving nurturing parents and families—can reverse the impact abuse or neglect has had on a child’s long-term well-being1.

Statistically, children who are adopted tend to utilize the services of mental health or special education providers more often than non-adopted children. While adoptees represent approximately 2 percent of the total U.S. population, they make up:

  • 5 percent of children receiving outpatient mental health services,
  • 10 to15 percent of children in residential treatment,
  • 6 to 9 percent of children who have learning disordersin the U.S.

Other factors may play a role in adopted children’s increased risk of psychological or learning disorders. These include3:

Factors Related to a Child’s Background:

  • Genetic predisposition to certain learning or mental health problems
  • Prenatal exposure to alcohol and other drugs, malnutrition or maternal diseases
  • Exposure to abuse, neglect, malnutrition, institutional care or violence prior to adoption
  • Multiple disruptions in placement prior to adoption
  • The child’s cognitive ability, temperament and quality of attachment to caregivers
An adopted child's mental and emotional health.

Factors Related to Life in the Adoptive Family:

  • The quality of the child’s relationships with the adoptive parents and siblings
  • The parents’ comfort level and openness to acknowledging and discussing relinquishment and adoption within their family
  • The quality of contact the child has with her birthfamily
  • The parents’ preparedness for adoption and the common hurdles that come with it
  • The parents’ sensitivity to the needs of their child and their willingness to seek professional help if needed

Factors Related to the Child Welfare and Mental Health Systems:

  • The number of disruptions in placement a child experiences and the quality of the transitions
  • The preparation for adoption and the specific needs of a child that are disclosed to parents by agencies or attorneys (and what information is given to agencies and attorneys by the child’s previous caregivers)
  • The level of understanding about trauma, relinquishment, and adoption that mental health professionals have and use when diagnosing the challenges faced by adopted children and adoptive families

Children who are adopted at any age, regardless of the type of adoption—domestic infant, older child, or international–are statistically more likely to be diagnosed with:

Children who are adopted at an older age from foster care or through international adoption are also more likely to be diagnosed with:

One challenge in treating mental health issues is that it is rare for one diagnosis to explain all of the child’s behaviors or symptoms. This is especially true for children who have experienced ongoing abuse or neglect. Some mental health professionals are now focusing more on complex trauma as a way to better understand, assess, and treat the detrimental effects that abuse, neglect, and institutional can life have on a child’s well-being.

Remember, just because a child is adopted or comes into adoption with one or more risk factors for psychological, emotional, or learning problems, it does not mean that he is destined for future problems. Children are resilient and bring multiple protective factors with them into their adoption. Adoptive families contribute to these factors when they provide a safe, stable, secure and loving home. Children also benefit when parents seek help early when they have concerns.


1Brodzinsky, David (2008). Adoptive Parent Preparation Project, Phase I: Meeting the Mental Health and Developmental Needs of Adopted Children. Evan B. Donaldson Adoption Institute. 

2Brodzinsky, David (2008). A Guide for Adoptive Parents: Understanding Some of the Psychological, Developmental, and Medical Challenges that Adopted Children May Experience. Evan B. Donaldson Adoption Institute.


Helpful Resources

Bethany Christian Services’ ADOPTSSM Child Trauma Assistance program serves children and families who are dealing with issues related to complex trauma.

The National Child Traumatic Stress Network (NCTSN) offers an online directory of their members who provide trauma-informed care.

The Mental Health Services Locator from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA) can help locate a mental health professional in your community.

Selecting and Working With an Adoption Therapist The Child Welfare Information Gateway provides helpful guidelines for what to look for and what questions to ask when looking for a mental health professional, defines different mental health professions’ approaches to providing care and offers links to additional sources of post-adoption support.