What Is Adoption-Competent Therapy and Why Does It Matter?

Most children who have been removed from their original home have experienced some trauma. If that trauma goes untreated, it can have serious, long-term effects. Parents and caregivers play a huge role in helping kids heal, but sometimes love and support at home aren’t enough. Some children need extra help, and that’s okay. We’d like to introduce you to the idea of adoption-competent therapy.

Think about it like this: when your child gets sick, you probably wait a day or two to see if rest, fluids, and medicine help. Usually, they bounce back on their own, but if they develop a high fever or new symptoms appear, you take them to the doctor.

Mental health is the same way, except instead of going to a pediatrician, you see a therapist.

Understanding the Mental Health Challenges In Kids Impacted by Trauma

Parenting a child who has experienced early trauma can bring unique struggles. Many parents feel comfortable talking about things like tantrums, school struggles, or food hoarding, but conversations about mental health can feel harder. There’s still a lot of stigma around therapy, and many caregivers feel overwhelmed or unsure where to turn.

If this sounds familiar, you’re definitely not alone.

According to the American Psychological Association (APA), mental health challenges are one of the greatest unmet needs of children who have experienced out-of-home placements. Adopted, foster, and kinship children are three to four times more likely to be diagnosed with a mental health disorder, and their families are three to five times more likely to seek therapy to help them heal and thrive.¹

What is Adoption-Competent Therapy?

Here’s the thing: not all therapy is the same. This is true for everyone, but it’s especially important for children who have been adopted or spent time in foster or kinship care. Experiences like being separated from family, moving between caregivers, or living through early trauma can create challenges that not every therapist fully understands.

For that, you want to find an adoption-competent therapist.

An adoption-competent therapist is someone who understands the complicated emotions and experiences that often come with adoption, foster care, or kinship care. They’re trained to help kids work through things like attachment struggles, grief, identity questions, and loss. They also understand how early childhood trauma can affect brain development and behavior.

Even though the name says “adoption-competent,” this kind of therapy isn’t only for adopted children. It can also help kids in foster care or kinship care, since many of the same experiences and challenges overlap.

What Makes Adoption-Competent Therapy Different?

There isn’t an official license that makes someone an adoption-competent therapist. Anyone can claim to be “adoption-competent” without really understanding what that means. Instead of a certification, adoption competency is about having the right knowledge, experience, and understanding to address the challenges posed by adoption, foster, or kinship care.²

Promoting Attachment

One of the biggest goals of this type of therapy is helping children build healthy attachments. That starts with caregivers. This means adoption-competent therapy shouldn’t happen in a bubble where the therapist works only with the child. Parents and caregivers need to be part of the process because healing often happens inside safe, supportive relationships. An adoption-competent therapist can help children feel more secure while also teaching caregivers practical tools for parenting children who have experienced trauma.

Download YOUR Free Guide on Talking with Kids About Adoption

Supporting Grief & Loss

Adoption-competent therapy also recognizes that grief and loss are a huge part of the story. Even in loving, stable homes, children may still grieve what they’ve lost. That could mean birth parents, siblings, culture, previous caregivers, or answers about where they came from. It’s tempting to focus on the positive side of adoption and avoid talking about those losses, but ignoring grief doesn’t make it disappear. A good therapist helps children acknowledge and process those feelings in healthy ways.

Addressing the Impacts of Trauma on Behavior

Behavior issues are the most common reason families seek therapy, but when the therapist doesn’t have a firm understanding of how early childhood trauma impacts a child’s brain development, and therefore their behavior, they can actually do more harm than good.

Trauma affects how a child’s brain develops, which can show up as meltdowns, emotional outbursts, anxiety, or trouble with self-control. An adoption-competent therapist looks beyond the behavior itself and works to understand the root cause. They help children learn coping skills and emotional regulation while also helping caregivers respond in ways that support healing.

And because there is a lot of overlap between the symptoms of trauma and the symptoms of mental illness, adoption-competent therapy places less importance on diagnosing specific disorders. Instead, it prioritizes understanding a child’s individual trauma history.

Promoting Healthy Identity Development

Identity development can also be complicated for our kids, especially during the teen and tween years. Kids who are adopted or in foster or kinship care often have extra questions about who they are and where they belong. An adoption-competent therapist can help children explore their personal history, understand the difficult parts of their story, and build a healthy sense of identity. They may also help families navigate open adoption relationships or support a child who wants to learn more about their birth family.

Including racial and cultural identity

Race and culture matter too. About a third of adoptions and foster care placements are transracial, and even kinship placements can be transracial, which can add another layer to a child’s experience. A therapist who understands race, identity, and cultural belonging can help children and caregivers talk through difficult experiences like discrimination, stereotypes, or feeling disconnected from cultural roots. In some cases, having a therapist who shares a child’s racial or cultural background may be especially helpful.

Adoption Competent Therapy Can Strengthen Your Child’s Foundation

Adoption-competent therapists can be hard to find, but it’s worth looking for someone who truly understands trauma, attachment, and the unique experiences of adopted, foster, and kinship children. If a specialist isn’t available nearby, a trauma-informed therapist can still be a strong option.

Every child deserves support from someone who understands their story and can help them move forward with confidence and hope from a firmer foundation.

Sources:
¹ Tori DeAngelis, “Helping Adoptive Families Thrive,” Monitor on Psychology 55, no. 6 (2024): 32; Amy D. Engler et al., “A Systematic Review of Mental Health Disorders of Children in Foster Care,” Trauma, Violence, & Abuse 23, no. 1 (2022): 255–64, https://doi.org/10.1177/1524838020941197; Shamele Hill, “I Spy Helpful Help: How to Find an Adoption-Competent Therapist,” National Council For Adoption, February 1, 2024, https://adoptioncouncil.org/publications/i-spy-helpful-help-adoption-competent-therapist/; Moira A. Szilagyi et al., “Health Care Issues for Children and Adolescents in Foster Care and Kinship Care,” Pediatrics 136, no. 4 (2015): e1131–40, https://doi.org/10.1542/peds.2015-2655.

² Anne J. Atkinson et al., “Adoption Competent Clinical Practice: Defining Its Meaning and Development,” Adoption Quarterly 16, nos. 3–4 (2013): 156–74, https://doi.org/10.1080/10926755.2013.844215; DeAngelis, “Helping Adoptive Families Thrive”; Hill, “I Spy Helpful Help”; Karen Peters et al., “Increasing Your Adoption Competency,” Insights Magazine, Fall 2023, https://bcacc.ca/wp-content/uploads/2023/09/Increasing-Your-Adoption-Competency-Karen-Peters-Renae-Regehr-Brenda-Hunt.pdf; Adoption Competent  Mental Health Professionals:  An Overview (National Center of Adoption Competent Mental Health Services, n.d.), https://bridges4mentalhealth.org/hub/adoption-competence/adoption-competent-mental-health-professionals-an-overview/.

Special thanks to Cait Johnson, a content contributor at Creating a Family, for this guest article.

Image Credits: AnnaStills - https://app.envato.com/photos/d4947a7b-c35c-4e0a-8d8f-4535b15ef23f; Prostock-studio - https://app.envato.com/photos/c5001ff8-feed-48cc-9438-7ee70fe8a9fd; POCSTOCK - https://app.envato.com/photos/7adfc247-617b-429c-bf3e-c1a0ecd796c0