Research Contributions: Strengthening Services for Members of the Adoption Triad

Madelyn Freundlich. Handbook of Adoption: Implications for Researchers, Practitioners, and Families. Editor: Rafael A Javier, Amanda L Baden, Frank A Biafora, Alina Camacho-Gingerich. Sage Publication. 2007.

Adoption is a complex service designed to meet the needs of a range of individuals. Adoption affects birthmothers and birth fathers who either through their own decisions or through the decisions of others relinquish their children to other families; the children for whom it serves as the path to new families and who, as adolescents and adults, must integrate the adoption experience into their lives; and adoptive mothers and fathers who rely on the adoption system to help them achieve parenthood. The effects of adoption on members of the triad (birth parents, adopted individuals, and adoptive parents) have been the subject of research for many years. The nature and scope of that research, however, have varied significantly, reflecting not only the realities of research interests but social values and professional concerns related to the practice of adoption.

This chapter examines the current state of adoption research with regard to each member of the triad. It outlines the major research interests and identifies the issues that have been the subject of relatively little research. Specifically, it considers the research on birthmothers and birth fathers in both domestic and international adoptions; adopted individuals, with focus both on adopted children and adolescents and on adult adoptees; and adoptive parents. It reviews the research on the issue of openness in adoption, with a focus on the research that has assessed the impact of openness on each triad member. The chapter concludes with an assessment of the contributions that research has made to current adoption practice.

Research with Birth Parents

Research with birth parents has addressed, to varying degrees, the impact of adoption on birth parents of infants, birth parents who relinquish their children to international adoption, and birth parents whose children are placed for adoption following involuntary termination of their parental rights. The research on birth parents of infants in the United States is far more comprehensive than the research on birth parents in other countries whose children are adopted by families in the United States and the research on birth parents whose rights are involuntarily terminated.

The Birth Parents of Infants

Research has provided some understanding of the impact of relinquishment and adoption on the birthmothers and birth fathers of infants. The decision whether to parent or place for adoption has been explored, although primarily in relation to unmarried teen women’s decision making (e.g., Dworkin, Harding, & Schreiber, 1993; Leynes, 1980; Resnick, 1984). Research has considered the psychological impact of relinquishment over the long term, but primarily, the focus has been on birthmothers, and only scant attention has been paid to birth fathers (Deykin, Patti, & Ryan, 1988; Edwards, 1995; Van Keppel & Winkler, 1983).

The decision to parent or to place for adoption

In line with the primary focus on the role of mothers in parenting in general (Rotundo, 1985), research has principally focused on the decision of women to parent their children or relinquish their children for adoption (Clapton, 1997). In the United States and Canada, researchers have been principally interested in the demographic characteristics of unmarried pregnant teen women who relinquish, and the focus has been on the social and psychological factors that influence these young women’s decisions (e.g., Chippendale-Bakker & Foster, 1996; Dworkin et al., 1993; Geber & Resnick, 1988). Although it is clear that a small and declining percentage of single pregnant adolescents decide in favor of adoption (Chandra, Abma, Maza, & Bachrach, 1999), those adolescents who make such a decision have been found to conform to a certain demographic and socioeconomic profile. An unmarried adolescent woman who relinquishes is more likely to

  • Be non-Hispanic White (Bachrach, Abma, Sambrano, & London, 1990; Chippendale-Bakker & Foster, 1996);
  • Be an older teenager (Bachrach, Stolley, & London, 1992);
  • Have an intact family (Namerow, Kalmuss, & Cushman, 1993);
  • Have a family member who is adopted (Resnick, 1984);
  • Have more years of education (Bachrach et al., 1992);
  • Have college-educated parents (Cushman, Kalmuss, & Namerow, 1993); and
  • Enjoy greater economic resources (Chippendale-Bakker & Foster, 1996; Leynes, 1980).

Research has also identified nondemographic influences on decision making by unmarried pregnant teen women. Four factors have emerged from this body of research. First, several studies have found that the mother of the pregnant teenager influences most the decision that she makes (Dworkin et al., 1993; Leynes, 1980; Resnick, 1984). Through the 1980s, the mothers of pregnant teens were most likely to promote a decision in favor of adoption (Resnick, 1984; Leynes, 1980). In more recent research, however, Chippendale-Bakker and Foster (1996) found that when the birthmother’s parents had influence in the decision-making process, it was more likely that the woman would choose parenting than adoption. The researchers raised the possibility that with changes in broader social attitudes about single parenting, families may have become more supportive of keeping grandchildren within the family. Second, studies have suggested that the father of the baby influences the consistency of the plan to place or parent the child (Blum, Resnick, & Stark, 1987; Dworkin et al., 1993; Geber & Resnick, 1988). When the father is involved, his values have been found to have significant social, psychological, and economic consequences for the pregnant adolescent woman (Bachrach, 1986).

Third, research has associated the residential environment of a maternity home with an increased likelihood that a teen woman will place her child for adoption. One study, for example, found that pregnant teen women who lived for any time during their pregnancies in a maternity facility were twice as likely to place their children for adoption as those who did not spend time in a residence (Namerow et al., 1993). Fourth, more recent research has found that contact with prospective adoptive parents (a variable not addressed in earlier research) influences young women’s decisions to parent or place their infants for adoption. In their study, Chippendale-Bakker and Foster (1996) found that when birthmothers chose and met the prospective adoptive parents, they were more likely to proceed with the adoption plan. birthmothers who participated in the study reported that meeting the prospective adoptive parents provided them with the reassurance that adoption offered a better option for their children than what they themselves could provide and that the particular adoptive parents were the right choice for their children.

The longer-term impact of the adoption decision on birthmothers

Two conflicting themes have emerged from the research on outcomes for unmarried women who choose to parent their children and women who choose adoption. The first theme is that adoption is a traumatic experience for the mother with negative consequences for her future well-being and personal and social functioning. The second theme is that adoption, by providing a positive alternative for an unplanned pregnancy, benefits the unmarried mother on a long-term basis and also significantly benefits her child.

The first theme, suggesting long-term negative effects for birthmothers, is most clearly developed in the empirical research from Australia. This research, which is so homogeneous that it is often characterized as the “Australian” point of view (Curtis, 1990), has consistently found that women who place their children for adoption are at significant risk of long-term physical, emotional, and interpersonal difficulties (Condon, 1986; DeSimone, 1996; McHutchinson, 1986; Van Keppel & Winkler, 1983). These studies suggest that many women who place their children for adoption suffer severe and debilitating grief that continues over time (Van Keppel & Winkler, 1983); have ongoing problems in their relationships with men and difficulties in parenting subsequent children (Condon, 1986); adjust poorly or not at all to placing their children for adoption (Bouchier, Lambert, & Triseliotis, 1991); and often experience symptoms similar to posttraumatic stress disorder (Wells, 1993).

In contrast, research in the United States has tended to highlight the benefits of adoption, emphasizing the risks associated with unmarried parenting and the benefits of adoption for the mother and child (Curtis, 1990). Much of the U.S. research has suggested educational and economic benefits for single women when they choose adoption instead of parenting and important benefits for their children when they are placed with adoptive families. These studies, which primarily focus on teen women, suggest that women who decide to parent their children are at heightened risk of lower educational achievement and lower rates of high school completion (Mott & Marsiglio, 1985); greater dependency on welfare benefits and poorer employment opportunities (Duncan & Hoffman, 1990); and higher divorce rates (Furstenberg, Brooks-Gunn, & Morgan, 1987). Studies have also indicated negative outcomes for children raised by their adolescent mothers: poorer health, higher levels of poverty, lower educational achievement, greater frequency of behavioral problems, and a higher risk of early sexual activity and pregnancy (Hofferth, 1987; Strobino, 1987). The thrust of this research is that mothers benefit from relinquishment in the form of higher socioeconomic status and higher levels of marital stability and that children benefit from the higher socioeconomic status they enjoy in their adoptive homes compared with the likely status of children if they were reared in a single-parent home (Kalmuss, 1992).

Some U.S. research, however, offers a point of departure to the overall positive findings regarding the effects of relinquishment on women. Some research finds mixed outcomes for unmarried teen women who choose parenting or adoption. Namerow et al. (1993), for example, compared unmarried teen women who placed their children for adoption and women who parented their children 4 years after the decision and found that women who chose to place their children had a higher overall satisfaction with life; scored higher on factors such as employment, finances, and the quality of their relationships with their partners; and reported a more positive future outlook. They also found, however, that teen women who placed their children for adoption reported a greater degree of regret about their decision.

Other U.S. studies that are more longitudinal in nature have found decidedly more negative outcomes for women who place their children for adoption (Brodzinsky, 1990). Edwards (1995), for example, found a range of poor psychological outcomes in her study of 56 birthmothers who had relinquished 16 to 51 years previously. The women she studied frequently described the experience of placing their children for adoption as the most traumatic event of their lives; related multiple symptoms of posttraumatic stress; and expressed a desire for search and reunion to fully heal. Similarly, Weintraub and Konstam (1995) found that birthmothers who had placed their infants for adoption during the 1960s and 1970s consistently reported pain associated with secrecy and isolation, a sense of stigmatization and personal disgrace, depression, perceptions of failures in relationships, difficulty “moving on” with their lives, and dissatisfaction with the services they received from helping professionals. More recent studies reach similar conclusions. Carr (2000) found that birthmothers experienced unresolved grief and negative effects on future relationships as well as an increased incidence of secondary infertility. Fravel, McRoy, and Grotevant (2000) found that birthmothers experienced an ongoing psychological presence of the child they relinquished, a finding that they found to empirically discredit the “happy ever after” myth, in which birthmothers supposedly forget their children and move on with their lives.

Research with Birth Fathers

Research has not fully addressed the role of the birth father in adoption or the effects on a birth father of the decision to place his child for adoption (Clapton, 1997; Grotevant, 2003). Mason (1995a) writes that “the birth father continues to be the least represented, least considered and least heard in adoption literature, conferences and advocacy efforts” (p. 29). Although, to some extent, birth fathers have become more involved in adoption decisions (Wiley & Baden, 2005), they have continued to be viewed as uninvolved in and unconcerned about planning for their children (Lightman & Schlesinger, 1982) and as unaffected by decisions related to the adoptive placements of their children (Mason, 1995b).

The current body of research, although extremely limited, suggests that multiple factors bear on birth fathers’ involvement in decision making about their children. Deykin et al. (1988), in a nonrepresentative sample of birth fathers identified through postadoption support and advocacy groups, found that a little more than half did not participate in the decision making regarding their children, and most (64%) had no contact with the child prior to the adoptive placement. In examining the factors related to the birth fathers’ lack of active involvement in, if not exclusion from, the adoption process, they found that the absence of birth fathers from the process was associated with four major factors: pressures from their families, a poor relationship with the birthmother, financial issues, and the attitudes of adoption agencies.

In another of the few studies with birth fathers, Cicchini (1993) interviewed 30 men in Western Australia who volunteered in response to articles and public appeals. As in the study by Deykin et al. (1988), Cicchini explored the birth fathers’ involvement in the decision-making process and found that the majority (66%) had no or only a minimal say in the adoption. He also sought information on the long-term impact of the adoption on the birth fathers and found that they consistently viewed relinquishment as “a most distressing experience.” His findings put into question the prevailing assumptions that birth fathers are irresponsible, uncaring, and uninvolved, and they suggest that the experiences and attitudes of these men are far from well-understood.

International Adoption and Birth Parents

Extremely little attention has been given to the birth parents of children who are adopted internationally. The relatively recent growth in international adoption, the diverse cultures in which birth parents live, and the circumstances surrounding many international adoptions have limited the understanding of the adoption experience for birth parents in other countries (Lee, 2003). As a consequence, birth parents of children adopted internationally “are often permanently invisible and silent” (Wiley & Baden, 2005). To the extent that there has been an examination of the impact of adoption on the birth parents of internationally adopted children, the focus has been on birthmothers and has been primarily descriptive in nature.

The limited research suggests that poverty and low social status typify the backgrounds of many women who place their children for adoption internationally. Pilotti’s (1993) study of the demographic characteristics of Latin American birthmothers who consented to the international adoptions of their children, for example, found that economic and social disadvantage uniformly characterized their backgrounds. birthmothers were found to be young (between the ages of 14 and 18), poor, unemployed or active in the informal sector as street vendors, beggars, or prostitutes, poorly educated, and from neglectful or abusive home environments. Defence of Children International, an organization that has studied the intercountry adoptions of children from a number of developing countries, has similarly concluded that “the vast majority (of birth parents) part with their children out of despair or with the hope to ensure the child’s welfare or survival” (Lücker-Babel, 1990, p. 393).

A study completed by Johnson, Banghan, and Liyao (1998) is one of the few efforts to understand the circumstances under which Chinese parents decide to abandon their children, thus making them available for international adoption. Of the 237 parents that the researchers interviewed, all but 3 were married and in their mid- to late 20s to late 30s. The researchers found that in 50% of the cases, the decision to abandon the baby was made by the child’s father, and in 40% of the cases the couple made the decision together. In contrast to Pilotti’s findings regarding birthmothers in Latin America, poverty did not appear to play a role in child abandonment in China.

More recently, Roby and Matsumura (2002) studied the factors associated with the decisions of birthmothers in the Marshall Islands to relinquish their children for adoption. As in Pilotti’s study, the researchers found that an environment of extreme poverty as well as a breakdown of traditional family support systems and an exploitation of the cultural understanding of adoption characterized the women’s experiences. Interviews with 73 Marshallese birthmothers who had placed their children for international adoptions revealed that most birthmothers did not feel financially prepared to care for their children; the great majority experienced considerable pressure from their own extended families to place their children for international adoption; and an astounding 82% believed, based on cultural beliefs that adoption is open and does not terminate parental rights, that their children would return to them at the age of 18 with a good education and material wealth.

No studies have been located on the impact of international adoption on Korean birthmothers despite the long history of international adoptions of Korean children. Wiley and Baden (2005), however, reported based on a visit to Ae Ran Won, a home for unmarried birthmothers in Seoul, that birthmothers expressed deep sorrow, regret, and shame for making the decision to place their children for adoption. These women felt, however, that no other options were available to them given the social stigma associated with unwed parenthood, the social structure of Korean society, and a lack of personal and social support.

Research has not addressed to any extent the effects of international adoption on birth parents in Russia and Eastern Europe. It is assumed that birth parents in these countries, as in Latin America, face dire economic circumstances that make it extremely difficult for them to parent their children and that, unlike in Latin America, alcohol abuse (as suggested by national rates of alcoholism) undermines their ability to parent (Aronson, 2000). Research, however, has not addressed the issues associated with relinquishment and abandonment in Russia and Eastern Europe or the impact of adoption on these birth parents.

Birth Parents Whose Rights are Involuntarily Terminated

As is the case with birth parents in the international arena, research has not focused to any significant extent on birth parents whose children are in foster care and whose rights are involuntarily terminated through a judicial process (see Edelstein, Burge, & Waterman, 2002). Mason and Selman (1997) note, “The voice of the non-relinquishing parents has not been heard” (p. 22). There has long been consensus that the impact of involuntary termination of parental rights and adoption on parents “is a subject which merits further research” (Hughes & Logan, 1993, p. 33), but the understanding of the experiences of this group of birth parents remains quite limited (Wiley & Baden, 2005).

The few studies that have been conducted in this area (all of which are from Great Britain) are consistent in their findings of long-term psychological distress as a result of involuntary termination of parental rights. Hughes and Logan (1993) identified two major characteristics of parents whose rights were involuntarily terminated: a continuing sense of anger and guilt that persisted long after their children were adopted and significant psychological problems. Mason and Selman (1997), in their study of 21 birth parents whose children were placed with adoptive families after involuntary termination of parental rights, similarly found that adoption “had a devastating and long-term effect on the lives of most of the parents, leaving them with feelings of isolation and emptiness” (p. 25). Birth parents reported adverse effects on their mental and physical health and ongoing concerns about their children’s whereabouts and well-being.

Charlton, Crank, Kansara, and Oliver (1998), in their interviews with 65 birth parents whose rights were involuntarily terminated, also found that many birth parents suffered from significant and long-term health problems that many parents related to mourning of their loss. The most commonly reported problems were physical symptoms associated with bereavement and trauma, such as sleeping problems, poor appetite, and dreams either about the loss of the child or about searching and the return of the child to them. The researchers further found that many birth parents described relationship difficulties, particularly with new partners. Some parents were reluctant to enter new relationships, and others felt a sense of isolation within relationships with individuals who had never known the children they lost.

Some, such as Berry, Barth, and Needell (1996), have suggested that because parents whose rights are involuntarily terminated have legal counsel, they are better protected than parents who themselves make an adoption plan, and, consequently, these parents may fare better psychologically. The studies of Mason and Selman (1997) and Charlton et al. (1998), however, found that the presence of legal counsel did not necessarily provide birth parents with a sense of empowerment. Mason and Selman (1997) found that birth parents had difficulties obtaining quality legal representation—that is, attorneys who had experience in working with involuntary termination of parental rights cases and the ability to present such cases effectively to the court. The court experience itself was traumatic for many birth parents who felt that they were being “publicly branded as bad parents” and that no one actually listened to what they had to say (p. 24). Similarly, Charlton et al. (1998) found in their interviews that irrespective of the presence of legal counsel, birth parents experienced the court process with a “sense of despair” because “everything had already been decided” (p. 37). The judicial process for birth parents “involve(d) not only loss of children, but also a loss of self worth and confidence” (p. 35).

Research with Adopted Persons

There has been considerable research interest in the psychological and behavioral adjustment of adopted children and adolescents as well as some work in the area of identity formation of adoptees. Adult adoptees, however, have largely not been the subject of empirical studies, other than in research on search and reunion. Only a few studies have focused on adult adoptees who were internationally adopted.

Adopted Children and Adolescents

The psychological and behavioral adjustment of adopted children and adolescents has been viewed from two different perspectives, both of which are reflected in the research. The traditional view is that adoption is a highly successful service for children who cannot or will not be raised by their birth parents, and therefore, any challenges associated with loss, rejection, and “differentness” are readily surmountable (Finley, 1999; Wilson, 2004). The other perspective is the epidemiological view that adoptees are more likely to have adjustment problems, as demonstrated by research that shows higher rates of psychopathology among adoptees and adopted individuals’ disproportionate representation among those served in mental health settings (Finley, 1999; Wilson, 2004).

The findings of studies on the psychological and behavioral adjustment of adoptees, perhaps the most extensive body of research on any single adoption issue, may be synthesized into three groups:

  • Research findings that suggest that there are no significant differences between adoptees and non-adoptees (Carey, Lipton, & Myers, 1974; Irhammar & Cederblad, 2000; Mikawa & Boston, 1968; Norvell & Guy, 1977; Plomin & DeFries, 1985; Stein & Hoopes, 1985; Thompson & Plomin, 1988).
  • Research findings that suggest that there are significantly higher rates of maladjustment among adopted individuals as compared with non-adopted persons (Bohman & Von Knorring, 1979; Dalby, Fox, & Haslam, 1982; Dickson, Heffron, & Parker, 1990; Holden, 1991; Lipman, Offord, Boyle, & Racine, 1993; Rogeness, Hoppe, Macedo, Fischer, & Harris, 1988; Schechter, Carlson, Simmons, & Work, 1964; Sharma, McGue, & Benson, 1996a, 1996b; Silver, 1970, 1989; Simon & Senturia, 1966; Slap, Goodman, & Huang, 2001; Verhulst, Althaus, & Versluis-den Bieman, 1990a, 1990b; Verhulst & Versluis-den Bieman, 1995).
  • Research findings that suggest that on certain variables related to emotional and behavioral adjustment, adopted children and adolescents function at a higher level than do nonadopted individuals (Marquis & Detweiler, 1985; Sharma, McGue, & Benson, 1998).

These diverse findings may be attributable to differences in the methodologies used (Sharma et al., 1998). These differences, which are not always made entirely clear in analyses of research findings in this area, relate to whether clinical or nonclinical populations are being studied; the types of adopted individuals who are studied (specifically, children adopted as infants versus children adopted at older ages); and the type of comparison group that is used (specifically, children in intact biological families or children in high-risk environments).

Clinical versus Nonclinical Populations of Adoptees

Research has been conducted with adoptees in both clinical and nonclinical settings, and the results vary accordingly. When clinical populations are studied, adoptees have been found to consistently use mental health services at higher rates than those of nonadoptees (Finley, 1999). Brodzinsky (1993) determined that although children adopted by nonrelatives constitute only about 2% of the child population, they make up about 5% of the children seen in outpatient mental health clinics and between 10% and 15% of the children treated in inpatient psychiatric or residential treatment settings. At the same time, studies suggest higher rates of adjustment difficulties and behavioral problems among adoptees. Studies of clinical populations have suggested that adoptees have higher levels of academic problems (Brodzinsky, Smith, & Brodzinsky, 1998), acting-out behaviors and hyperactivity (Moore & Fombonne, 1999; Rosenberg, 1992), and externalizing behaviors (Cadoret, 1995) and that they score more poorly on measures of self-esteem (Rohner, 1986).

Research findings related to the outcomes of adoptees in nonclinical settings, in contrast, show differences between adopted and nonadopted persons but at a far less dramatic level than is evident in clinical settings (Sharma et al., 1998). One study of adoptees conducted in public schools, for example, revealed that differences in adjustment among adoptees on factors such as drug use, school adjustment, optimism, and antisocial behavior were fairly small when compared with levels of adjustment for nonadoptees (Sharma et al., 1996a).

These differences in the research findings raise methodological issues. Specifically, the research has been criticized because there are no comprehensive data on the number of adoptions or the incidence of referrals of adoptees to mental health services on which to base the estimates that appear in the research; the characteristics of birth parents, adoptees, and adoptive parents have changed over time, which may undermine the validity of comparisons between different cohorts; and researchers may have potential biases when they are aware that the subjects are adopted (Finley, 1999). At the same time, criticism has been directed at conclusions about the level of adoptees’ adjustment problems based on their higher usage of mental health services. Warren (1992), for example, maintains that overrepresentation of adoptees in clinical settings is associated more powerfully with factors related to adoptive parents than with the nature or frequency of problems among adoptees: adoptive parents’ heightened sensitivity to the risks that adoption poses for their children and their greater readiness to seek mental health services for their children; their perceptions of problems associated with adoption as potentially threatening to the integrity of the family and, as a result, their higher motivation to seek treatment; and the higher socioeconomic status of adoptive families, which gives them greater access to mental health services.

Infant versus Older Child Adoption

Studies of adoptees’ psychological adjustment have not consistently distinguished outcomes for individuals adopted as infants from outcomes for individuals adopted at older ages (Finley, 1999). A lack of clarity regarding the population of adoptees under study may account, to some degree, for the conflicting findings related to adjustment outcomes for adoptees (Groza & Rosenberg, 2001). Although there are findings to the contrary (e.g., Moore & Fombonne, 1999), research has generally supported the belief of many adoption professionals that children adopted at older ages are at greater risk of psychological and behavioral problems (Juffer & van Ijzendoorn, 2005; Sharma et al., 1998; Barth & Berry, 1988). Sharma et al. (1996b), for example, found in their multistate study of 4,682 adopted children that when compared with children adopted as infants, children placed at older ages had greater adjustment difficulties, and children placed with adoptive families after the age of 10 years had the most serious problems, including higher rates of substance abuse and antisocial behavior. Other studies have associated older age at the time of adoptive placement with early disruptive life experiences that may affect adopted children’s later adjustment. These studies have found that two factors—a history of multiple placements prior to adoption and a history of abuse or neglect—place an adopted child at increased risk for developing adjustment problems (Barth & Berry, 1988; Groza & Ryan, 2002; McRoy, Grotevant, & Zurcher, 1988; Verhulst & Verslusis-den Bieman, 1992).

Adoptees as Compared with Non-adoptees in Intact Families and with Children at Risk

A third issue in the research regarding adoptees’ overall adjustment relates to the use of different comparison groups and the meaningfulness of the findings depending on the group with which adoptees are compared. A number of studies have compared adoptees with non-adopted persons raised in intact families, and these studies consistently have found lower levels of functioning among adoptees (Bohman & Von Knorring, 1979; Dalby et al., 1982; Holden, 1991; Rogeness et al., 1988; Schechter et al., 1964; Sharma et al., 1996a; Silver, 1970, 1989; Simon & Senturia, 1966; Verhulst et al., 1990a). Another body of research has compared adoptees with children and adolescents in foster care or institutional settings or with children subject to maltreatment by their birth families, and these studies have found that adopted persons function far better (Bohman, 1970; Bohman & Sigvardsson, 1990; Hodges & Tizard, 1989; Triseliotis & Hill, 1990).

The findings have differential applications, an aspect of the research that has not always been acknowledged in discussions of adoptees’ adjustment and overall well-being (Sharma et al., 1998). The research that has compared adoptees with children and adolescents in intact families, on the one hand, has sought a better understanding of how well adopted persons fare as compared with nonadopted persons and, with that focus, has provided a basis for assessing the needs of adoptees and their families and developing responsive services. On the other hand, the research that has compared adoptees with children in foster care or institutional care or in abusive or neglectful birth family environments has sought to evaluate the role of adoption as an alternative for children whose birth families cannot or will not care for them. With that focus, the research has provided a basis for understanding the benefits of adoption in relation to nonpermanent, nonfamily, and/or compromised family environments. The contributions of each body of research are distinct and provide an understanding of different aspects of adoption in relation to outcomes for adoptees.

Identity Formation

In contrast to the fairly extensive body of research on adoptee psychological and behavioral adjustment, there has been less attention from a research perspective on adoptees’ identity formation. To some extent, the research has considered the question of whether the process by which adoptees form their identities differs from typical patterns of identity development or presents greater challenges for adopted adolescents compared with adolescents who are not adopted. The clinical literature, however, is far more extensive than is the research on this issue (Freundlich & Lieberthal, 2000). The clinical literature suggests that adoptees in adolescence may face a more complex task in resolving identity issues than do nonadoptees because they confront hurdles related to adoption in addition to issues that parallel those faced by nonadopted adolescents (Brodzinsky, 1987; Goebels & Lott, 1986; Rosenberg, 1992). Some clinicians believe that adolescent identity struggles may be intensified by the fact of adoption itself, with early loss exerting significant effects on identity formation (Frisk, 1964; Hoopes, 1990). Other clinicians identify specific aspects of adoption that may have a particular impact on identity: adoptees’ physical dissimilarity to adoptive family members; fantasies about birth parents who are not known to them or not present in their lives; and the need, in some cases, to separate from both adoptive and birth families (Schechter, 1960; Sorosky, Baran, & Pannor, 1975).

Research has not provided empirical validation for such postulated psychological phenomena as “family romance” (Hajal & Rosenberg, 1991; Lawton & Gross, 1964; Rosenberg, 1992) or “genealogical bewilderment” (Lifton, 1994; Sants, 1964). It has, however, contributed to a better understanding of the social factors associated with adopted adolescents’ identity formation, particularly adoptees’ relationships with their adoptive parents (Hoopes, 1990; McWhinnie, 1969; Rickarby & Egan, 1980; Sabalis & Burch, 1980; Stein & Hoopes, 1985) and the impact of adoptive parents’ attitudes toward adoption on adolescents’ sense of security and sense of identity (Blum, 1976; Schoenberg, 1974; Sorosky, Baran, & Pannor, 1984; Stein & Hoopes, 1985).

Adult Adoptees

There is relatively little research with adult adoptees in which the adoptees themselves (as opposed to their parents) are the primary source of information. To the extent that such research exists, it is primarily in the area of search and reunion and focuses on adoptees’ motivations for searching.

Research has provided conflicting findings regarding the extent to which adoptees’ interest in search is connected to the quality of their relationships with their adoptive parents. Triseliotis (1973) found that search was associated with high levels of dissatisfaction with the adoption experience; other studies have indicated that most adoptees who search are quite satisfied with their adoptions (Day & Leeding, 1980); and yet other studies have found more or less equal distributions of satisfaction and dissatisfaction among adoptees who search (Kowal & Schilling, 1985; Schechter & Bertocci, 1990). Research also offers conflicting findings on the relationship between adoptees’ fantasies of their birth parents and adoptees’ interest in searching for their birth parents. Schechter and Bertocci (1990), for example, found that searchers were more likely to have positive images of their birth parents, and Triseliotis (1973) found that searchers were likely to hold negative views. A few studies have explored other possible motivations for search and suggested that searching may be associated with adoptees’ perceptions that they are markedly different in physical appearance (Stein & Hoopes, 1985) or in personality (Schechter & Bertocci, 1990) from their adoptive parents and are motivated by a desire to find family members who physically or temperamentally resemble themselves.

As limited as the information is about adult adoptees who search and their search experiences, even less is known about adoptees who do not choose to search. The few studies that have compared nonsearchers with searchers suggest that nonsearchers tend to be more satisfied with the level of their adoptive parents’ communications with them about their adoptions (Aumend & Barrett, 1984); score higher on scales measuring self-esteem and self-concept (Sobol & Cardiff, 1983); and score lower on scales measuring self-abasement (Reynolds, Eisnitz, Chiappise, & Walsh, 1976). The research provides little information on the reasons why adoptees choose not to search when they have information regarding their birth parents. The limited research on this issue suggests that the decision not to search is connected to adoptees’ fear of not being able to fully integrate the information they might receive (Frisk, 1964); a greater interest in medical and genealogical information than in actual contact with birth family members (Blum, 1976); and a desire to avoid having information about themselves made available to their birth parents (McWhinnie, 1969). It is clear that the understanding of search is partial at best because most adoption research has focused on adoptees who search (Wegar, 1997).

International Adoptees

Research with international adoptees is extremely limited. Much of the research with internationally adopted children and adolescents has focused on issues of racial and cultural identity (Andujo, 1988; McRoy, Zurcher, Lauderdale, & Anderson, 1982; Simon & Alstein, 1992). Few studies have been conducted with adults who were adopted internationally as children, the exceptions being nonrepresentative surveys of adult Korean adoptees (Evan B. Donaldson Adoption Institute, 1999) and adult Vietnamese adoptees (Evan B. Donaldson Adoption Institute, 2000). These surveys reveal that the experiences of adoptees from Korea and Vietnam are highly individualized. Nonetheless, international adoptees in both surveys consistently reported high levels of racism and discrimination as they were growing up in American communities. These adult adoptees also reported that many, if not most, individuals who are adopted internationally seek connections with their birth culture, connections that are often more powerful for them than the possibility of connecting with their birth families.

Research with Adoptive Parents

The research with adoptive parents is surprisingly limited, given the emphasis in practice on serving adoptive parents, particularly in the arenas of infant and international adoption. The two areas that have been subject to some study are the psychological and social aspects of adoptive parenthood and the qualifying process through which it is determined whether an individual will be allowed to adopt. More recently, some work has focused on the perceptions of prospective adoptive parents about the adoption process itself (Katz, 2004).

Research regarding the psychological and social implications of becoming an adoptive parent primarily focuses on adoption in relation to infertility. A study by Berry and colleagues (1996) revealed that most adopters have tried to become pregnant before adopting. The researchers found that 83% of those who adopted through private agencies, 80% of those who adopted independently, and 50% of those who adopted through public agencies had unsuccessful attempts at pregnancy. Although significant percentages of adopters reported that they adopted because they were unable to have a biological child, the data also make it clear that slightly more than one half of families who adopted children from the foster care system had biological children of their own (Berry et al., 1996).

Parents who choose to adopt for reasons other than infertility, however, have not been the subject of research to any meaningful extent. Instead, the research has focused on individuals’ experiences as they realize that biological parenthood will not be possible and that parenthood can be achieved only through adoption. As one example, Sandelowski (1995) has described the experiential course of infertile couples who, having made the decision to adopt, move toward the point at which a child will be placed with them. She found that this experience involves certain unique psychological processes that distinguish the achievement of social (as opposed to biological) parenthood: creation of “a temporal order” to cope with the unmarked adoption waiting period so that the couple can gain control over the uncertainty and avoid “living only to wait for a child”; the construction of a biography for the child that meshes with the adopters’ own biography and emphasizes that the child is “loved” by them; and finally, staking “a claim” to “own” the child as their own. The “claiming” process principally involved adopters’ concerns about themselves as “genuine” parents: their anxieties about being “accepted” as the child’s “real parents”; their efforts to deemphasize “the importance of the blood tie between parent and child”; and their struggles to establish a “right” to their child “by emphasizing the close biological or biographical match between them and their child” (Sandelowski, 1995, p. 130).

Although the home study process has been dealt with in the practice literature (e.g., Barker, Byrne, Morrison, & Spenser, 1998; Rycus, Hughes, & Goodman, 1998), there is remarkably little research that attempts to validate the processes that are used to accept or reject adoptive applicants. Brown and Brieland (1975), in their early work and one of the few studies on this issue, examined the processes that agencies used in evaluating couples who sought to adopt infants. They reported the results of two nationwide studies of 184 social workers from 27 adoption agencies in which social workers indicated, based on the criteria they generally used in their own practice, whether they would accept or reject certain prospective adoptive couples. The researchers found that there was a statistically significant level of agreement among the social workers in their judgments, but they emphasized that from a practical standpoint, the level of agreement was not “high enough” (p. 293). They found that within many agencies, social workers were evenly split as to whether a particular applicant couple should be accepted or rejected, suggesting that social workers’ judgments of the applicants’ strengths and weaknesses were based on widely different value systems. The researchers highlighted the need to identify criteria essential to assessment decisions and use standardized procedures to obtain and give weight to the most relevant data.

These recommendations notwithstanding, there have been no outcome studies evaluating different methods of assessing adoptive parents in terms either of their effectiveness in recruiting adoptive families or of achieving optimal outcomes for children (Sellick & Thoburn, 1996). There is some evidence from nonclinical studies that adoptive parents tend to demonstrate good psychological health and levels of marital adjustment at the time of adoption (Levy-Shiff, Bar, & Har-Even, 1990), outcomes that might be associated with the use of effective assessment processes. It is equally possible, however, that the overall health and stability of adoptive parents is the result of self-selection.

Openness in Adoption

One area in which there has been research with regard to all members of the triad is the increasingly common practice of open adoption. Researchers have considered the impact of greater openness on birth parents, adoptive parents, and, to a lesser degree, adopted children (Haugaard, Moed, & West, 2001).

Although concerns have been expressed that openness may prolong birth parents’ unresolved grief (Byrd, 1999), several researchers have found that birth parents view greater openness as beneficial (Christian, McRoy, Grotevant, & Bryant, 1997; Fratter, 1991; Grotevant & McRoy, 1997; Hughes, 1995; Lauderdale & Boyle, 1994; McRoy & Grotevant, 2002; Sullivan & Lathrop, 2004). Grotevant and McRoy (1997), in their longitudinal research on the impact of open adoption on all members of the triad, found that birth parents benefited from greater openness. They compared the experiences of birthmothers in fully disclosed adoptions (in which information was shared directly between birth parents and adoptive parents, usually through telephone calls and face-to-face meetings); confidential adoptions (in which no information was shared between birth and adoptive parents after the adoptive placement); and mediated adoptions (in which information was exchanged between birth and adoptive families through an adoption agency staff member acting as an intermediary). The researchers found that birthmothers in fully disclosed adoptions had higher levels of grief resolution regarding the adoption decision than did birthmothers who had no contact with the adoptive family or whose contact with the family had terminated. They also found that birthmothers in fully disclosed adoptions enjoyed levels of self-esteem equivalent to those of birthmothers in closed and mediated adoptions. Similarly, Cushman, Kalmuss, & Namerow (1997), in their study of adolescent birthmothers who resided in maternity homes at the time of relinquishment, found that the receipt of letters and pictures was associated with significantly less worry and slightly higher levels of relief. birthmothers who visited the adoptive family or spoke with them over the telephone reported significantly lower levels of grief, worry, and regret and a greater sense of relief and peace about the adoption.

Concerns have also been expressed that adoptive parents will experience openness as an intrusion into the integrity of their family (Hollinger, 2000). Research suggests that, to the contrary, adoptive parents find greater connections with birth parents to be positive. Siegel (1993), for example, probed the sentiments of 21 adoptive couples in open adoption arrangements. She found that despite initial fears and concerns about openness, most of the respondents identified open adoption with more autonomous parenting and family functioning. They reported that open adoption gave them a sense of control with regard to birth parents; prepared them to effectively fulfill their roles as parents; dissolved fantasies about their child’s birth parents; and alleviated guilt and any moral apprehension about “having someone else’s child” (p. 18). Interestingly, the adoptive parents reported that openness was “simply not that much of a concern” when weighed against the more difficult issues of infertility: finding a child to adopt; “dealing with unresponsive and obstructive social workers, lawyers, and medical personnel” (p. 20); and coping with the lifelong issues involved in every adoption.

Other research on the impact of open adoption on adoptive families likewise indicates that the “concerns and dire warnings of open adoption critics” have not come to fruition (Brodzinsky et al., 1998, p. 83). Studies have found that adoptive parents in open arrangements report positive benefits for themselves and their families, including a high level of satisfaction with openness and good relationships with birth parents (Belbas, 1987; Etter, 1993; Gross, 1993; Haugaard, West, & Moed, 2000); a greater sense of entitlement to their child (Belbas, 1987; McRoy & Grotevant, 1988); fewer concerns about attachment issues (Silverstein & Demick, 1994); and less concern about efforts by birth parents to reclaim their child (Belbas, 1987).

The research on the impact of openness on adopted children has been limited, largely because the systematic practice of openness is a fairly recent development. It is too early to assess the full impact on young adoptees participating in current research, although the knowledge base is growing (Berry, 1991; Cubito & Brandon, 2000; Gross, 1993; Howe, Feast, & Coster, 2000; Muller & Perry, 2001). In 1998, Grotevant and McRoy, based on their longitudinal study of openness in adoption, reported initial findings on children’s perceptions of their open adoptions. They found that the majority of children in their study (all of whom were adopted as infants) were curious about their birth parents and birth siblings. Children with less information about their birth parents were more likely to wonder about their birth parents’ physical appearance, health, and well-being. Children with more information tended to wonder about what their birth parents had done since they had contact with them last and when they would meet again, or if they had had no contact with their birth parents, whether they would meet. The researchers found that children did not feel confused or anxious by open adoption arrangements, but instead, openness gave “adoptive parents an opportunity to facilitate their child’s understanding of adoption” (pp. 104–105). In the second wave of the study, McRoy and Grotevant (2002) found that adjustment for children with contact with their birthmothers depended on adoptive family relationships and collaboration between the adoptive family and the birthmother. The researchers highlighted the need for more information about the effects of open adoption on adoptees’ adjustment as they develop throughout adolescence into adulthood.

The research on the impact of openness on older children in foster care who are adopted also suggests certain benefits to children. Research has shown that, in general, children who maintain ongoing contact with their birth parents have a higher sense of well-being and that contact promotes healthy development (Garrison, 1983). Studies have indicated that the involvement of the birth family and their cooperation with the adoption promote the child’s ability to accept the adoptive family (Borgman, 1981); resolve the child’s loyalty conflicts after the adoption (Smith & Howard, 1994); and minimize negative behavioral responses to the changes brought about by adoption (Smith & Howard, 1994). There appear to be situations, however, in which ongoing contact between birth parents and their children may not be appropriate for children in foster care who are adopted. Appell (1996), for example, has suggested that these situations may include cases in which there have been multiple unsuccessful placements of the child and the presence of the birth parents presents a risk of future disruption; there is a history of severe child abuse within the birth family; birth parents, as a result of mental health, substance abuse, or other problems, are likely to be unduly disruptive to the adoption; and birth parents continue to present a risk of severe and imminent harm to the child. Research has not addressed the impact of openness on children under such circumstances, suggesting that much more needs to be understood about openness in the adoption of children in foster care.

An Assessment of the Contribution of Research to Adoption Practice

Research has made a number of important contributions to adoption practice. It has informed practice with respect to those members of the triad already of great concern to practitioners—unmarried women who may place their newborns for adoption, adopted children, and, to some extent, adoptive parents. Research has addressed the factors associated with women’s, and particularly adolescents’, decision making regarding adoption and has attempted to assess the longer-term impact of relinquishment on birthmothers. There are marked discrepancies in research findings in this area, however, which raise a number of questions. It is not clear whether the different findings on outcomes for birthmothers are attributable to the degree to which such studies are longitudinal in nature, different samples of birthmothers who participate in the studies, or the overall cultural climate in which the research is conducted. At the same time, it is clear that the psychological and social ramifications of relinquishment on middle-income, White women have been of considerable research interest, whereas the impact of adoption on birthmothers in other countries and women whose parental rights are involuntarily terminated has not garnered equivalent attention.

With regard to the research on adopted children and adolescents, the findings are variable with regard to psychosocial and behavioral functioning, making it difficult to interpret clearly the impact of adoption on adoptees. Nonetheless, the research highlights a number of issues related to psychological well-being and identity formation that require greater attention in both adoption and mental health practice. Primary attention has been given to the impact of adoption on children adopted as infants as opposed to children who are adopted at older ages.

With regard to adoptive parents, the research has primarily been sociological in nature as opposed to practice based, with principal attention given to personal and social definitions of the role of “parent.” The findings in relation to the adoption qualification process are limited, and neither practice nor research has made significant contributions to the understanding of who should and who should not be permitted to adopt. It is clear, however, that the level of research interest in infertile individuals who may adopt far exceeds the interest in individuals who adopt children in foster care, despite the growing and pressing need to recruit greater numbers of families for these children.

Research has not focused significantly on the experiences of birth fathers. Similarly, in adoption practice, birth fathers have not been the subject of significant attention and have often been discounted in terms of any “real” role in adoption. Birth fathers continue to be viewed in stereotypic terms. Research has also not extensively focused on adult adoptees. Because they are not involved in the adoption placement decision and process, there has been a tendency to view adopted adults as having no meaningful role in adoption. Adult adoptees are often overlooked altogether or considered only in relation to their interactions with other triad members through search and reunion.

With regard to greater openness in adoption, research thus far has offered limited guidance. Research in this area, however, continues to expand, especially through the work of McRoy and Grotevant, and a more solid knowledge base that addresses the many challenges in this area is developing. Until there is a clearer understanding of the impact of openness across all forms of adoption, however, serious questions remain about the quality of services that are being provided. The failure to address openness in the adoption of children in foster care, in particular, reflects the overarching need for greater research with regard to the adoption of older children with histories of abuse or neglect.


Adoption research has focused on infant adoption, with principal interest in birthmothers’ decision making, the impact on women when they relinquish their newborns, the psychological and behavioral impact of adoption on children adopted as infants, and the effects of infertility and adoption on infant adopters. It has made important contributions to practice in each of these areas. Far less attention has been given to practice issues in international adoption and the adoption of children in foster care, despite the fact that both these forms of adoption have assumed more prominent roles with the significant increase in the number of children abroad and in the U.S. foster care system who need adoptive families. As future agendas for research are developed, the need for empirical contributions to advance practice in the fields of international adoption and the adoption of children in foster care must be recognized.

Reflection Questions

  1. What accounts for the research focus on the birthmothers of infants placed for adoption and the relative lack of research interest in the experiences of birth fathers, the parents of children adopted internationally, and parents whose rights are involuntarily terminated?
  2. On which issues should research focus in the future to develop a fuller understanding of the impact of adoption on adopted children, adolescents, and adults?
  3. Why might the absence of research on the experiences of adoptive parents be considered “surprising”? Is additional research on their experiences needed?