The mental health of adopted adolescents has received surprisingly little research attention. Yet, there are several compelling reasons to systematically explore this issue.
One is the oft-cited dictum that adopted adolescents are over-represented in mental health treatment populations. Another is the set of challenges presented by adolescence. Questions of identity blossom during this time. While most adolescents expend considerable energy sorting out issues of purpose, meaning, and one's place in the world, adopted adolescents could face additional questions that may interfere with the satisfactory resolution of these issues. Anecdotal accounts often surface in the media of adopted adolescents who lose their way.
It is imperative, then, to shed greater scientific light on how adopted youth navigate through adolescence. How psychologically healthy are they? Does adolescence present greater risks for adopted youth than for their non-adopted counterparts? What factors promote or interfere with psychological health? To explore these and related issues, Search Institute launched, in 1989, a four-year study of adopted adolescents and their families. Supported by a major grant from the National Institute of Mental Health, this project generated an in-depth look at 715 families who adopted infants between 1974 and 1980. When the survey was conducted (1992-1993), these young people were in the age range of 12-18. The sample of families was randomly selected from the records of 42 public and private adoption agencies in the four states of Colorado, Illinois, Minnesota, and Wisconsin. A total of 881 adopted adolescents, 1,262 parents and 78 non-adopted siblings participated in this study, making it the largest study of adopted adolescents and their families ever conducted in the United States. The participants completed extensive and confidential survey instruments containing a wide range of psychological and family measures, including many scales that were specially developed for this study.
Identity: Who Am I? On a series of measures about the formation of identity, we find little evidence that adopted adolescents are particularly vulnerable. Some are, of course, but at rates no more pronounced than for other adolescents. Adopted adolescents are as likely to report positive identity as their non-adopted siblings. When asked to compare themselves to others their age, adopted adolescents report satisfactory resolution of identity concerns at rates as high or higher than their peers. And on an index of self-esteem, adopted adolescents compare favorably to a public school sample of 12-18 year olds in the same four states, based on other Search Institute research. For most adopted adolescents in this study, adoption is seen as a fact of life that is accepted with relative ease. Most have positive affect about adoption and only 27 percent report that adoption "is a big part of how I think about myself." Overall, we see that adoption does not typically complicate the period of adolescence. This finding runs counter to the classical understanding of adopted adolescents. Why the disparity? The classical view is based to a considerable extent on clinical samples and a wider spectrum of adoptions, including those that occur after infancy. When the focus is on agency-assisted infant adoptions, the journey through adolescence appears to be, on average, less stormy.
Child-Parent Attachment Strong emotional bonds between child and parent(s) are a crucial factor in child and adolescent development. Such bonds increase the probability of successful socialization. Though adoption can conceivably interfere with the attachment process, we find extremely high rates of strong attachment to adoptive parents. Adopted adolescents are as deeply attached to parents as are their non-adopted siblings. Fifty-four percent are strongly attached to both parents; 30 percent are deeply attached to one parent; and only 16 percent are not strongly attached to either parent. Equally compelling is the high percentage (95%) of parents who say they experience strong attachment to their adopted child. The vast majority of adoptive families, then, master a crucial process important to healthy development.
Family Dynamics One of the most salient characteristics of families in this study is their stability. Only 11 percent of adolescents report divorce or separation compared to 28 percent in a national sample of adolescents. This may be due, in part, to the pre-adoption screening process typically employed by agencies during the 1970s. Adoptive families in this study typically evidence a high level of strength in terms of warmth, communication, discipline, and cohesion. Less functional parenting styles, such as authoritarian decision-making, are rare. Communication about adoption requires a delicate balance. Either too little or too much communication can be detrimental. The former may represent a denial that blocks needed opportunity by adopted youth to express and explore feelings. Too much communication, on the other hand, may foster an unsettled and insecure sense of self. The vast majority of adoptive families successfully take the middle road. The normative communication pattern is one of quiet openness: Communication about adoption, when it occurs, is done with relative ease and comfort. Communication about adoption is infrequent; the vast majority of teenagers report two or fewer conversations about adoption with either parent in the past year. Yet most also feel comfortable talking with parents about adoption issues. Thus, for most families, talking about adoption is "no big deal" in either tone or frequency. The adoption literature describes a number of "role handicaps" that are normative for adoptive parents. These include unresolved feelings about infertility, discomfort in talking about adoption with their children, feeling stigmatized, and experiencing trauma during the adoption process. Though each of these "handicaps" is a potentially serious dynamic requiring recognition and attention, each is relatively uncommon among these parents.
Examining Mental Health Most of the adopted adolescents in this study demonstrate successful adjustment at a rate that rivals adolescents in general. (On several measures of psychological health, adopted adolescents are slightly healthier than a comparison sample of public school adolescents. On an index of clinical symptoms, they are slightly higher than found in a national norm group.) This conclusion runs counter to conventional portrayals of adoption that focus more on problems than successes. This study joins a growing body of literature that documents that adoption is not, in and of itself, a liability. Based on multiple indices of psychological health, we estimate that at least three-quarters of adopted adolescents are within the zone of positive psychological health. What accounts for this? Based on an analysis of the factors found to be related to mental health and well-being, we posit that the well-being of adopted adolescents is fueled by six important dynamics:
In this study, we see a preponderance of families who know both how to be good families and how to be good adoptive families. When this skill is combined with infant adoptions, the possibility of strong attachment, positive identity formation, and affirmation of adoption is high.
Keys To Success In Adoptive Families This study pinpoints a number of factors crucial for the important task of raising healthy adopted children into and through the challenging years of adolescence. Granted, we are looking in this work at a way of "doing" adoption which is becoming harder and harder to replicate. The families in this study adopted early (the first 15 months of their child's life), have typically received (and some continue to receive) support and nurture by professionally trained agency staff, and have remained intact, with extremely low divorce and separation rates. Since the 1970s, when all the families in this project adopted the children reflected in this report, all three of these distinctive features have changed dramatically. We cannot overstate the power of early placement. It is likely a key ingredient in the successful attachment of child to parent (and vice versa). And such attachment, which is strong among the vast majority of families in this study, is an important precursor to positive identity and psychological health, both of which are commonplace among the adolescents in this study. Providing families with support and training is also key. These do not necessarily have to be delivered through agencies, but agencies have great potential to organize and deliver services which may be more difficult to deliver when families adopt independently. It is an important issue, then, that most infant adoptions now occur independently, often without the organized and orchestrated energy of staff to provide training and support. If this trend continues, it is essential that support and training be central components of all types of adoption placements. Though most adolescents and families in this study demonstrate strength, there are no guarantees. Even in the best of families, some adoptedÑas well as non-adoptedÑyouth lose their way. When this happens in adoptive families, there is a tendency to blame adoption. While there are certainly some adoptive families which are less than competent, one should not lose sight of the constellation of factors that can shape an adopted child's life. Among these are genetic predispositions, prenatal care, and pre-placement history, each of which can impact a life course. It is unclear exactly how these factors work or how they interact with adoption and adoptive family life. To finger adoption as the culprit when a child experiences a lack of health fails to do justice to this complex interplay. Ultimately, the bottom line is that most adopted children and teenagers succeed. Though we find that adopted adolescents tend to do as well as adolescents in general, such comparisons need to be treated with caution. There are, for example, demographic differences between the adopted sample and the published samples to which we compare them. To be more precise about how well adopted teenagers do in comparison to other teenagers, we have proposed further research to the National Institute of Mental Health that includes a careful look at a matched comparison group. A decision about this continuation grant will be made in the fall of 1994.
The Study At A Glance Study Purpose This study was designed to examine the mental health and service needs of adolescents who were adopted as infants. Description Of Sample A total of 715 families with adolescents who were adopted as infants participated in the study. This sample included 1,262 parents, 881 adopted adolescents, and 78 non-adopted siblings. What Is Unique
Sampling Method In-depth surveys were mailed to a representative sample of families who adopted infants through agencies between 1974 and 1980. Surveys were completed by families from March 1992 to August 1993. Agency Participation A total of 42 agencies (including 8 public agencies) in the four states of Colorado, Illinois, Minnesota, and Wisconsin cooperated in the study. Support This four-year, $1 million study was made possible through funding from the U.S. Department of Health and Human Services, National Institute of Mental Health.
By: Dr. Peter L. Benson, Dr. Anu R. Sharma, L.P. and Eugene C. Roehlkepartain