Clinical Perspective: Psychoeducation for Pre-adoptive Families

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With the media focusing more and more on adoption - and usually sensationalizing it -the public's impression is often that of an adversarial relationship that must exist between the birth family and adoptive family. In many of the contested adoption cases, it looks like neither set of parents can do what is in the best interest of the child. Most certainly, the professionals (lawyers, judges, therapists) do not seem to understand the systematic problems for the families and the dysfunction these problems will cause the child who is placed in this adversarial arena.

Adoption can be a very positive way to create a family. It is estimated that adoption affects the lives of forty million Americans. Given these numbers and the fact that adoption is becoming more prevalent in the 1990's, it will be increasingly important for clinicians to be skilled in working with the unique issues that face adoptive family systems. Marriage and Family Therapists can help these complex families. They can normalize and demystify the process of adoption so that those involved can be treated honorably and be prepared to handle the related issues. Mental health professionals should focus on family preservation when possible, a preventative approach to consultation, and the welfare of the children involved.

The Birth Family

When women and their partners deal with and untimely pregnancy, the decision about whether or not to surrender a child for adoption should be educated with all options. Family preservation and kinship arrangements should be explored prior to any discussion of adoption. Therapists should discuss with clients the kinds of adoption available and the post-traumatic effects that they will encounter over time. The pain of loss is great, but the reasons for adoption being considered indicate that parenting that child might also prove very difficult. Adoption is a serious option that indicates that being a parent might be a difficult choice for these people at this time. Birth parents need to speak with someone in the beginning of their decision making process.

Once they've had adequate psychoeducation and counseling then the possibility of a good and healthy adoption is secure.

Currently, birth parents often want to be involved in the selection of adoptive parents. What parents would not want to know something about where his or her child is going? Meeting the adoptive parents before a decision is made is not uncommon. Yet the trend appears not toward open adoption but toward semi-open adoption. In semi-open adoption, there is a one-time meeting between birth parents and pre-adoptive parents and first names are exchanged. An emotional connection is made between both parties as is an agreement to have the agency of adoption professionals act as an intermediary in the yearly (or otherwise decided by parties) exchange of letters and pictures and update medical information. Semi-open adoption allows the birth parent to feel more connected to the child they cannot parent.

Closed adoption - the traditional form since the 1930's offers no identifying information, very little non-identifying information, and no agreement for future meeting. Open adoptions can vary a great deal, from regular meetings to occasional written contact. In all forms of adoption, birth parents terminate parental rights, and the adoptive parents take them on. The emotional and psychological connections are never terminated.

Pre-Adoptive Parents

Understanding what precedes the adoption, whatever type it may be, is important. A majority of pre-adoptive couples have struggled with issues of infertility for years. The pain and loss that result from constantly hoping for a birth child and undergoing invasive medical, pharmacological, and surgical procedures (that strain a couple's relationship) make adoption seem like additional hoops to jump through to be parents. Like birth parents, adoptive parents feel like victims of the process. Pre-adoptive parents often suffer a lack of understanding by some family, friends, and society. This results in a subtle but lifelong experience of pain, guilt, shame and loss.

The panacea, in days of old, was adoption. We now know that adoption does not fix infertility. It fixes the desire to parent, and adoption is a wonderful way to do that. But the issues of never seeing a child of "one's own" continue to exist. These issues exist for extended family members as well. (Parents of pre-adoptive couples benefit a great deal from being included in psychoeducation and counseling around adoption.)

In therapy, a 30-year-old female adoptee clearly remembered and recounted a day soon after her eighth birthday. Louise was very close to her adoptive mom. They were making her room into a "big girl's room." They chose flowered wallpaper, colors for paint, and a lovely bedspread and curtains. The grandparents came to dinner soon after the project's completion. Mom and Louise each held one of Grandma's hands and told her to close her eyes. They excitedly worked her to the door of the newly arranged room. They flung open the door and gleefully told her to open her eyes. Grandma opened her eyes and looked all around the room. "What a beautiful room for someone else's child," she said.

This was not a "wicked" grandmother, although both mother and daughter were devastated by her comment. This was an aging mother who suffered from the loss of never seeing her birth grandchildren. Psychoeducation, even 22 years after this unforgettable day, could help the entire family. And psychoeducation, before adoption for parents and their extended family or community will lead to more support of the adoptive family, along with a greater understanding of participants' own feelings. A Marriage and Family Therapist can help families discuss and make sense of these issues in the pre-adoptive process. Gay and lesbian couples and single parents who adopt will also benefit from pre-adoption psychoeducation about the added complexities that their families will face.
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